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Terms in this set (47)

Correct Answer: 1,2,3,4

Rationale: Due to the long-term commitment (6-8 weeks) in isolation and the uncertainty of treatment's outcomes, coping mechanisms often become ineffective due to the variety of physical, mental, and financial issues that are faced during this life-threatening process. Role strain, depression, pain, loss of independence, and severe fatigue all contribute to difficulties in coping. Fatigue occurs with stem cell transplants from the complete bone marrow suppression, which causes anemia and decreased RBC to carry the oxygen needed for cellular functioning. Emotional stressors also create a fatigue while dealing with the entire treatment process. Major depression is not uncommon post-transplant. Family commitment and role changes are needed while hospitalized, since strict isolation occurs during the transplant treatment process. Children might not be allowed to visit, causing further separation by family members. Job roles (family dynamics) might be changed during hospitalization and recovery. Prior to transplant with stem cells, the patient receives total body chemotherapy, causing bone marrow suppression. Therefore, the WBCs are depleted prior to the transplant, and the ability to fight off an infection is decreased significantly, creating the need for strict isolation for the patient. With chemotherapy, there often is a tendency for nausea and vomiting, leading to fluid loss and not fluid retention. Therefore, the patient is more likely to have a "deficit" rather than an "excess" when receiving stem cell transplants. Steroid treatment can cause a fluid shift, but usually not an "excess fluid balance."