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This chapter is from the book

This chapter is from the book

Polycythemia Vera

The polycythemia vera disorder is characterized by thicker than normal blood. With polycythemia vera, there is an increase in the client's hemoglobin to levels of 18 g/dL, RBC of 6 million/mm, or hematocrit at 55% or greater and increased platelets.

The clinical manifestations that are assessed in clients with polycythemia vera relate to the increased viscosity of the blood. The following list describes some of the symptoms that are associated with polycythemia vera:

  • Enlarged spleen
  • Ruddy or flushed (plethoric) complexion
  • Angina
  • Thrombophlebitis
  • Dizziness
  • Tinnitus
  • Fatigue
  • Paresthesia
  • Dyspnea
  • Pruritus
  • Burning sensation in fingers and toes (erythromelalgia)

If polycythemia vera is not treated, few patients will live longer than two years. Treatments revolve around reducing the thickness of the client's blood and providing an easier flow of blood through the blood vessel. This is accomplished by

  • Repeated phlebotomies (2–5 times per week)
  • Increasing hydration (3 liters of fluid a day)
  • Promoting venous return through
    • Elevation of legs when sitting
    • Use of support hose
  • Pharmacological interventions, including the following:
    • Anticoagulant therapy
    • Allopurinol for increased uric acid levels
    • Persantine for ischemic symptoms
    • Hydroxurea (Droxia)
    • Low-dose aspirin
    • Agrylin
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