Polycythemia Vera
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The Opposite of Anemia: Polycythemia Vera
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Patho
- ⇑ WBC
- ⇑ RBC
- ⇑ Platelets
- Clients are prone to clots and do not live very long. Die from a myocardial infarct or a stroke.
- Cause: cancer usually in older adults 50- 75 y/o
- Too many RBCs leading to increased hematocrit, hypervolemia, hyperviscosity, and hypertension
- Clients with COPD who have chronic hypoxia may start making for RBCs to compensate.
- Red face due to excess RBCs
- Purple or cyanotic skin and mucuous membranes due to hypoxic blood
- Severe burning/itching due to thick, poorly oxygentated blood.
- Hypertension (remember blood is thick)
- Dilated vessels
- Clots due to obstructed blood flow.
- Infarcts of organs (heart, brain)
- Visual disturbances, headache, orthopnea, gout!
- gout: painful swollen joints (usually big toe)
- Orthopnea is due to heart failure
- dizziness, feelilng of fullness in the head, Tinnitus
- Think hypertension s/s
- Uric acid and potassium increase (gout, renal failure, hyperkalemia)
- Apheresis/phlebotomy: removal of RBCs to reduce viscosity.
- Hydration to reduce viscosity
- No iron supplements
- Anticoagulations (makes sense since at risk for clots)
