A history of hepatitis C five years previously.

The clinical picture varies with the type pf leukemia as well as the treatment implemented, so the following must be assessed: Based on the assessment data, major nursing diagnoses for the patient with ALL may include: Main Article: 5 Leukemia Nursing Care Plans. Leukemia is the most common cancer in children and teens, accounting for almost 1 out of 3 cancers. Chemotherapy is the major form of treatment for leukemia.

During induction chemotherapy, the leukemia patient is severely immunocompromised and at risk of serious infection. The life cycle of the white blood cells is changed and the cells do not die when they should, thus accumulating and taking up space. If this activity does not load, try refreshing your browser. position, physical activity/nonactivity, and so forth. A Mayo Clinic physician talks with a woman about her diagnosis. Acute Lymphocytic Leukemia (ALL) does not cause gastric distention. Your time with your doctor is limited, so preparing a list of questions can help you make the most of your time together. Being ready to answer them may allow more time later to cover other points you want to address. Client’s description of response to pain, specifics of pain inventory, expectations of pain management, and acceptable level of pain. : CBC, noting whether WBC count falls or sudden changes occur in neutrophils; Decreased numbers of normal/mature WBCs can result from the disease process or chemotherapy, compromising the immune response and increasing risk of infection. In today’s leukemia lecture, we’ll be talking about the basic treatments and interventions that primarily influence your patient’s condition. Rationale: Prevents cross-contamination/reduces risk of infection. Nursing Management: The Patient with Leukemia. The focus of documentation should include: Here are some practice questions for this study guide: In Exam Mode: All questions are shown but the results, answers, and rationales (if any) will only be given after you’ve finished the quiz. B. Used to prevent/treat hemorrhage.

Radiation treatment for other types of cancer can result in leukemia. to a private room so she will not be infected by other patients and health care workers.

Watch for signs of minor bleeding, such as petechiae, ecchymosis, conjunctival hemorrhage, epistaxis, bleeding gums, bleeding at puncture sites, vaginal spotting, heavy menses. Provide comfort measures (e.g. There are many types of leukemia. C. Heart sounds.

Leukemia is cancer of the blood forming tissues and usually involves the white blood cells. Verbalize understanding of therapeutic needs. Radiation therapy.

A client with leukemia has neutropenia. However, later on, the nurse may need to assist the child and family with coping since, Option D: Injections should be discouraged, owing to increased risk of, Option A: Bone deformities don’t occur with leukemia, Although. Before a stem cell transplant, you receive high doses of chemotherapy or radiation therapy to destroy your diseased bone marrow. Option C: Mature cells aren’t produced in adequate numbers, and hirsutism and growth delay can be a result of large doses of steroids but isn’t common in leukemia. For example, the drug imatinib (Gleevec) stops the action of a protein within the leukemia cells of people with chronic myelogenous leukemia. Encouraging adequate intake of iron-rich foods. Radiation therapy may be used to prepare for a stem cell transplant. Which of the following other assessment findings may suggest leukemia? Nurses caring for these patients must remain knowledgeable about new treatments and their management. Once you are finished, click the button below. Rationale: Eliminate peripheral venipuncture as source of bleeding. We will bring in books and magazines for entertainment.

Nurseslabs – NCLEX Practice Questions, Nursing Study Guides, and Care Plans, Practice Test: Acute Lymphocytic Leukemia, Nurses as Cancer Insurgents: 9 Guidelines for Cancer Screening Tests, Cancer and Oncology Nursing #1 (56 Questions), Cancer and Oncology Nursing #2 (60 Questions), Cancer and Oncology Nursing #3 (25 Questions), Cancer and Oncology Nursing #4 (20 Questions), Cancer and Oncology Nursing #5 (15 Questions), Arterial Blood Gas Interpretation for NCLEX (40 Questions), Arterial Blood Gas Analysis Made Easy with Tic-Tac-Toe Method, Select All That Apply NCLEX Practice Questions and Tips (100 Items), IV Flow Rate Calculation NCLEX Reviewer & Practice Questions (60 Items), EKG Interpretation & Heart Arrhythmias Cheat Sheet. Symptoms: pallor of nail beds and conjunctiva, petechiae (small hemorrhagic spot on skin), tachycardia, dyspnea, weight loss, fatigue. Be alert for signs of serious bleeding, such as headache with change in responsiveness, blurred vision, hemoptysis, hematemesis, melena, hypotension, tachycardia, dizziness. Risk for infection related to decreased primary and secondary responses, OUTCOMES. Decreasing Hb/Hct is indicative of bleeding (may be occult). Whenever she gets bumped by her classmates at school, bruises then adorn her arms. All rights reserved. anxiety, fear, Reports of pain (bone, nerve, headaches, and so forth), Guarding/distraction behaviors, facial grimacing, alteration in muscle tone. Death occurs when the abnormal cells encroach on vital tissues and cause complications and organ dysfunction. Riggin ER. Cleanse skin with antibacterial solutions.

D: Anemia, not polycythemia, occurs. Stacy is discharged from the hospital following her chemotherapy treatments. Rationale: Facilitates relaxation, augments pharmacological therapy, and enhances coping abilities. Stem cell transplant. Investigate reports of pain.

As the disease progresses, the patient may have central nervous system (CNS) dysfunction with seizures, decreased mental status, or coma and renal insufficiency. Advertising revenue supports our not-for-profit mission.

A platelet count of 25,000/microliter is severely thrombocytopenic and should prompt the initiation of bleeding precautions, including monitoring urine and stool for evidence of bleeding. Research on predisposing factors isn’t conclusive but points to some combination of viruses, immunologic factors, genetic factors, and exposure to radiation and certain chemicals. If loading fails, click here to try again. C: The prognosis of ALL usually is good. Also, this page requires javascript. D: Pneumonia, both viral and fungal, is a common cause of death in clients with neutropenia, so frequent assessment of respiratory rate and breath sounds is required. The aspirated bone marrow is mixed with heparin. Rationale: Minimizes need for/enhances effects of medication. A CBC (complete blood count) reveals a platelet count of 25,000/microliter. %PDF-1.7 %����

Avoid mouthwashes with alcohol. To treat leukemia in the brain or prevent it from spreading to the brain and central nervous system, methotrexate and cytarabine/cytosine arabinoside are injected into the spinal canal. Rationale: Leukemia is usually treated with a combination of these agents, each requiring specific safety precautions for patient and care providers. Nursing responsibilities: private room, no raw fruits or vegs, small frequent meals, O2, good skin care. If so, when? Patients need to have laboratory tests ordered and the results closely monitored due to the potential for leukopenia and cardiac toxicity. Wearing of a mask is required to prevent transport of communicable diseases. White blood cells are considered as the soldiers or police officers of the body, and their main objective is to fight off illnesses and infections. C: Mature cells aren’t produced in adequate numbers, and hirsutism and growth delay can be a result of large doses of steroids but isn’t common in leukemia. Signs and symptoms of infectious process.

Clotting times would be prolonged. Evaluate skin turgor, capillary refill, and general condition of mucous membranes. Pneumonia, both viral and fungal, is a common cause of death in clients with neutropenia, so frequent assessment of respiratory rate and breath sounds is required. Identify individual risk factors and appropriate interventions. What is the peak age range in acquiring acute lymphocytic leukemia (ALL)? Imatinib (Gleevec) is sometimes used to treat ALL. Provide quiet environment and uninterrupted rest periods. Rationale: Maintains fluid/electrolyte balance in the absence of oral intake; prevents or minimizes tumor lysis syndrome, reduces risk of renal complications. The patient is under local anesthesia during the procedure. The integration of psycho-oncology into cancer care has significantly helped alleviate emotional and psychological distress for both patients and caregivers. 5. However, a better understanding of the biology of CLL, a younger patient, the development of new purine analogues, and bone marrow transplant clinical trial success have … What you need to know about leukemia. Up to 90% of acute leukemias are a form of lymphocytic leukemia, acute lymphoblastic leukemia (ALL), which is characterized by the abnormal growth of lymphocyte precursors called lymphoblasts. 827 0 obj <> endobj Pneumonia, both viral and fungal, is a common cause of death in clients with neutropenia, so frequent assessment of respiratory rate and breath sounds is required. Acute leukemias have large numbers of immature leukocytesand overproduction of cells in the blast stage of maturation.

Antibiotics and immunoglobulins help to prevent or fight infections.

The factor whose prognostic value is considered to be of greatest significance in determining the long-range outcome is the histologic type of leukemia.

Nurseslabs.com is an education and nursing lifestyle website geared towards helping student nurses and registered nurses with knowledge for the progression and empowerment of their nursing careers. Saline or steroid eyedrops for relief during treatment with cytarabine/cytosine arabinoside. which means "blood”. Allopurinol doesn’t act in the manner described in the other options. Which of the following would the nurse identify as the initial priority for a child with acute lymphocytic leukemia? Type of treatment and client’s sex. B: Iron-rich foods help with anemia, but dietary iron is not an initial intervention. Rationale: Conserves energy for healing, cellular regeneration. Transfusions of red blood cells and platelets. Rationale: Effects of leukemia, anemia, and chemotherapy may be cumulative (especially during acute and active treatment phase), necessitating assistance. Avoid invasive procedures and trauma to skin or mucous membrane to prevent entry of microorganisms. A bone marrow biopsy is often done at the same time. Option B: Activity level is decreased in patients with leukemia as they experience fatigue more frequently than normal.

Or if a first round of ATRA and chemotherapy does not work, arsenic trioxide may be used.

Fresh flowers, fruit, and plants can carry microbes and should be avoided. This is called intrathecal chemotherapy. Mayo Clinic, Rochester, Minn. August 9, 2017. Practice Mode: This is an interactive version of the Text Mode. Here's some information to help you get ready, and know what to expect from your doctor. Encourage frequent turning and deep breathing. "Have you noticed a change in sleeping habits recently? Transfusion of red cells is indicated for severe anemia.

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