Discharge And Home Healthcare Guidelines

FOLLOW-UP. Teach the patient to report any signs and symptoms of a delayed reaction, such as fever, jaundice, pallor, or fatigue. Explain that these reactions can occur anytime from 3 days after the transfusion to several months later.

Explain that the patient should notify the primary healthcare provider if she or he develops any discomfort in the first few months after transfusion. Attributing these signs to specific diseases may make the patient unnecessarily anxious, but the patient should know to notify the healthcare provider for anorexia, malaise, nausea, vomiting, concentrated urine, and jaundice within 4 to 6 weeks after transfusion (hepatitis B); jaundice, lethargy, and irritability with a milder intensity than that of hepatitis B (hepatitis C); or flulike symptoms (HIV infection).

Bone Cancer DRG Category: 239

Mean LOS: 6.8 days Description: MEDICAL: Pathologic Fractures and Musculoskeletal and Connective Tissue Malignancy

Bone cancers are sarcomas—that is, cancers of connective tissue. It is estimated that there will be 2570 new cases of bone cancer diagnosed in 2005, and there will be 1210 deaths from bone cancer in this country. Primary bone cancers are relatively uncommon, constituting less than 0.2% of all cancers. Most (60% to 65%) tumors of the bone are secondary, or metastatic, ones from other primary tumors. Cancers originating in the osseus, cartilaginous (chrondrogenic), or membrane tissue are classified as bone cancer. Cancers originating from the bone marrow are usually classified as hematologic cancers. The most common type of primary bone cancer is osteosarcoma (Table 2).

An osteosarcoma arises from osteoblasts (bone-forming cells) and osteoclasts (bone-digesting cells) in the interior of the bone; it occurs most commonly in the femur but also in the tibia and humerus.

• TABLE 2 Major Types of Primary Bone Cancer
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