leukemia

Question 1

leukemia

Answer 1

is a cancer of blood cells, the neoplasm develops in bone marrow & moves to the blood, spleen, lymph nodes, & other tissues
-an over proliferation of immature wbcs can completely replace the normal bone marrow precursors, leading to a decrease in rbcs

Question 2

acute lymphocytic leukemia ALL

Answer 2

is the most aggressive & is the most common type of cancer in children but can also affect adults

Question 3

acute myeloid leukemia AML

Answer 3

can also be aggressive & is more common in older adults

Question 4

chronic lymphocytic leukemia CLL

Answer 4

is slower growing & is one of the most common types of leukemia in older adults

Question 5

s/s

Answer 5

-fatigue
-fever
-night sweats
-bleeding
-weight loss
-anorexia or loss of appetite
-petechia

Question 6

possible causes

Answer 6

-exposure to radiation, chemicals
-exposure to strong electromagnetic fields
-maternal use of alcohol, cigs, or DES

Question 7

AML prognosis

Answer 7

50-80% chance of remission but decreased for adults over 50-60

Question 8

CML prognosis

Answer 8

3-4 yr survival rate

Question 9

ALL prognosis

Answer 9

long term survival possible for children

Question 10

CLL prognosis

Answer 10

median survival ab 10 yrs

Question 11

subjective nursing assessment

Answer 11

-ask ab s/s including; fatigue, weakness, headache, fever, anorexia, weight loss, bleeding, bone pain
-document reports of sob, chest pin, urticaria, rash
-obtain medical tx

Question 12

objective nursing assessment

Answer 12

-pallor
-petechiae
-splenomegaly, heptatomegaly
-sternal tenderness
-anemia

Question 13

lab tests

Answer 13

-cbc w differential
-bone marrow biopsy & aspiration
-lumbar puncture = eval csf
-blood cultures if febrile

Question 14

medical management

Answer 14

-chemotherapy is the mainstay of tx for most leukemias
-radiation
-chemo w stem cell transplant
-targeted therapy to attack specific cancer cells w less harm to normal cells
-antibiotics if infection occurs
-blood transfusion may be needed to correct anemia
-antiemetics
-varicella zoster immunoglobulin if the pt is exposed

Question 15

ALL tx

Answer 15

3 stage therapy
-1. induction therapy
-2. CNS prophylaxis
-3. postremission therapy

Question 16

AML tx

Answer 16

2 stage therapy
-1. induction
-2. post remission

Question 17

CML tx

Answer 17

hydroxyurea or busulfan to decrease wbc

Question 18

CLL tx

Answer 18

-stable, asymptomatic pts do not requite tx
-symptomatic, tx w chemotherapy & corticosteriods

Question 19

education for male pts

Answer 19

educate ab possibility of sperm banking

Question 20

education for female pts

Answer 20

-fertilize eggs b4 rad therapy
-many chemotherapy agents induce early menopause
-if pt maintains menstruation, they should avoid use of tampons
-counsel ab possibility of secondary malignancies
-monitor for infections in pts who have received rad/chemo esp if spleen has been removed
-careful dental & oral therapy care
-during tx, pts should avoid receiving vaccines or being around fam who have recently received a live vaccine