Nursing care of the blood cell transplant recipient.

OBJECTIVES: To review the complications of blood cell transplantation (BCT) and their clinical and nursing management. DATA SOURCES: Review articles, research studies, book chapters pertaining to the complications of peripheral stem cell transplantation and the management of these complications. CONCLUSIONS: As the number of patients receiving BCT increases, complications related to stem cell mobilization, harvesting, dose-intensive conditioning therapy, infusion, and engraftment are being documented with increasing accuracy. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses will be caring for an increasing population of patients undergoing BCT. Although complications of both bone marrow transplantation and BCT are similar there are unique differences. Support and nursing interventions are of utmost importance for BCT patients and their family caregivers.

Delayed complications of bone marrow transplantation: an update.

PURPOSE/OBJECTIVES: To review the delayed complications of bone marrow transplantation (BMT) with respect to specific problems, prognoses, causes, times of onset, and medical and nursing management. DATA SOURCES: Books, chapters, published professional articles, computerized data bases, and proceedings of national meetings. DATA SYNTHESIS: BMT, a life-saving measure for many patients with cancer, is associated with serious delayed complications. Morbidity and mortality from multisystem chronic graft-versus-host disease (GVHD), severe immunosuppression, sterility, growth and development problems, cataracts, relapse, secondary malignancies, and other complications can occur 100 days or more after BMT. Complications result from the effects of high-dose conditioning regimens, GVHD, transplant-related problems, and disease relapse. CONCLUSIONS: BMT is a life-saving measure associated with complications that can occur months to years after transplantation. Considerable research is needed to improve treatment for these complications and to increase the length of disease-free, long-term survival. IMPLICATIONS FOR NURSING PRACTICE: Nurses working with patients before and after BMT can be instrumental in managing long-term complications. Preparation of patients and families prior to, during, and after BMT can help alleviate anxieties throughout the continuum of recovery. Since the population of patients who have undergone BMT is growing, nurses in community and ambulatory settings need to include evaluation for physical and psychological sequelae of BMT as part of routine assessment, and symptom management as part of standard care.

Home care of the bone marrow transplant recipient: high tech, high touch.

Home care professionals are responsible for keeping abreast of the latest therapies used to treat specific disease entities to provide comprehensive and quality care. This article gives an overview of bone marrow transplantation, a complex treatment used for malignant and nonmalignant diseases. The transplant process, complications, and the role of home care for this population are discussed.

Bone marrow transplant therapy in the home.

All of the psychological, physical, and economic complications of bone marrow transplant must be understood to ensure comprehensive management and continuity of care to each BMT recipient. Caregivers in both the hospital and home care setting need to be cognizant of each patient's issues and health care needs.

Auditory semantic, syntactic, and retention errors made by aphasic subjects on the Token Test.

The Token Test was administered to 25 mild aphasic and 25 matched normal subjects for the purpose of determining the linguistic nature of the auditory verbal comprehension error responses. As was expected, the aphasic subjects obtained significantly poorer scores on the Token Test than did the normal subjects, with minimal overlap between the two groups. In Parts I-IV, the errors were exclusively semantic, and reflected only the amount of required verbal memory. In Part V, the syntactic structures vary, and the aphasic subjects showed a similar pattern of difficulty as did the normal subjects. Syntactic errors were more prevalent than semantic errors in Part V, suggesting that syntactic complexity was the most important factor in verbal comprehension on this part. In comparison to previous research utilizing the Token Test with normal children, the aphasic subjects in the present study generally had high error rates on the same items as did the children.