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Other Therapy: Immunosuppression therapy with such agents as antithymocyte and antilymphocyte globulin or cyclosporine may be tried in patients who are not candidates for bone marrow transplant; antibiotics may be given if infection or sepsis is present. Androgens, a controversial treatment, may be prescribed to stimulate bone marrow function; sargramostim, a recombinant human granulocyte-macrophage colony-stimulating factor capable of activating mature granulocytes and macrophages, may be tried.

Independent

Perform meticulous hand washing before patient contact. If protective isolation is required, use gloves, gown, and mask, and make sure that visitors do the same. Report any signs of systemic infection, and obtain the prescribed cultures. Provide frequent skin care, oral care, and perianal care to prevent both infection and bleeding. Avoid invasive procedures, if possible. When invasive procedures are necessary, maintain strict aseptic techniques and monitor the sites for signs of inflammation or drainage. Teach the patient and significant others symptoms of infection and to report them immediately to healthcare providers.

To help combat fatigue and conserve patient energy, plan frequent rest periods between activities. Instruct the patient in energy-saving techniques. Encourage the patient to increase activities gradually to the level of maximum tolerance.

Some patients with aplastic anemia undergo bone marrow transplants. Preoperatively, teach the patient about the procedure. Explain that chemotherapy and possible radiation treatments are necessary to remove cells that may cause the body to reject the transplant. Offer support and reassurance.

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