Ch 34 and ch 15 Nur 424 final
what is the hallmark of myelodysplastic syndrome?
cytopenias
Which patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)?
A 72-year-old patient with a history of cancer
what would a cbc look like for someone with acute myeloid leukemia?
decreased RBC and platelets
what is leukemia a proliferation of?
granulocytes lymphocytes
what are the major types of lymphoma?
non hodgkin's and hodgkin's
what is multiple myeloma a disease of?
the plasma cell
What is Non-Hodgkin's Lymphoma?
uncontrolled multiplication and metastasis of undifferentiated lymphocytes
what age group is ALL most common in?
young children peak incidence is 4 years old
what is acute lymphocytic leukemia?
- rapidly progressive blood cancer - undifferentiated precursor cells - common in children - responds well to treatment
what is polycythemia vera?
A blood disease in which there is an increase in erythrocytes, leukocytes and platelets
A 48-year-old female recently diagnosed with leukemia presents with increased immature lymphocytes, decreased granulocytes, and normal erythrocytes. The client most likely has which type of leukemia?
Chronic lymphocytic leukemia
What is acute myeloid leukemia?
Neoplastic accumulation of immature myeloid cells (>20% in the BM)
A client with acute myeloid leukemia has a fever. What pathophysiological process does the nurse recognize is the cause of the client's fever?
Neutropenia
what is CRAB in multiple myeloma?
calcium elevated renal failure anemia bone lytic lesions
what is multiple myeloma?
cancer of plasma cells ( the most mature B lymphocyte)
What is Hodgkin's lymphoma?
cancer of the lymph nodes
what is leukemia?
cancer of white blood cells granulocytes, lymphocytes
what would the cbc be like in myelodysplastic syndrome?
macrocytic anemia
what is the specific immunoglobulin secreted by the tumor cells in multiple myeloma called?
monoclonal protein or M protein
what is the second most common hematologic malignancy in the us?
multiple myeloma
The nurse is discussing disorders of the hematopoietic system when a client asked about erythrocytosis. What disease will the nurse mention with a primary characteristic of erythrocytosis?
polycythemia vera
What is myelodysplastic syndrome?
clonal disorders of the myeloid stem cell that causes dysplasia in one or more of the cell lines
Chronic myeloid leukemia is uncommon in people younger than ______?
20 years old
what is the average age of someone with chronic myeloid leukemia?
64 years ol
A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see?
Hypercalcemia
A client with multiple myeloma reports severe paresthesia in the feet. When planning care for the client, which priority nursing diagnosis will the nurse choose?
Risk for falls
The nurse is caring for a patient who will begin taking long-term biphosphate therapy. Why is it important for the nurse to encourage the patient to receive a thorough evaluation of dentition, including panoramic dental x-rays?
The patient can develop osteonecrosis of the jaw.
What is hematopoiesis?
blood cell formation
what is the only cure of myelodysplastic syndrome?
bone marrow transplant
what is leukocytosis?
increase in WBC (increase in leukocytes)
what is essential thrombocythemia?
Very high platelets, stainable Fe, ↓c-mpl
The nurse is teaching a client with acute lymphocytic leukemia (ALL) about therapy. What statement should be included in the plan of care?
"Intrathecal chemotherapy is used primarily as preventive therapy."
A patient with AML is having aggressive chemotherapy to attempt to achieve remission. The patient is aware that hospitalization will be necessary for several weeks. What type of therapy will the nurse explain that the patient will receive?
Induction therapy
The nurse is administering packed red blood cell (RBC) transfusions for a patient with myelodysplastic syndrome (MDS). The patient has had several transfusions and is likely to receive several more. What is a priority for the nurse to monitor related to the transfusions?
Iron levels
A nurse prepares teaching for a group of clients with chronic myeloid leukemia (CML). When planning the teaching on medication adherence, which factors associated with lower oral therapy adherence will the nurse keep in mind? Select all that apply.
Living alone Low socioeconomic status Not participating in a clinical trial Taking medication independent of meals
what is a lymphoid?
Originate from lymphoid stem cells and produce leukocytes
The nurse is caring for a client with multiple myeloma. Why would it be important to assess this client for fractures?
Osteoclasts break down bone cells so pathologic fractures occur.
A client with multiple myeloma presents to the emergency department and reports excessive thirst and constipation. Family members report that the client has been confused for the last day. Which laboratory value is most likely responsible for this client's symptoms?
Serum calcium level 13.8 mg/dl
The nurse is educating a client taking imatinib mesylate for treatment of leukemia. What should the nurse be sure to include when educating the client on the best way to take the medication to optimize absorption?
Take antacids if needed for gastrointestinal (GI) upset 2 hours after taking imatinib mesylate.
what is hematopoietic malignancies?
they originate in the hematopoietic stem cell, the myeloid or in the lymphoid cell
true or false. acute myeloid leukemia affects all ages
true, peak incidence age of 67 years old
what is chronic lymphocytic leukemia?
- slowly progressing from malignant clone of B lymphocytes - partially differentiated cells - common in older adults - responds poorly to treatment; usually slow to heal
The nurse cares for an older adult client with unprovoked back pain and increased serum protein. Which hematologic neoplasm does the nurse suspect the client has?
Multiple myeloma
What is chronic myeloid leukemia?
mutation in the myeloid stem cell with uncontrolled proliferation of cells -philadelphia chromosome
what is lymphoma?
neoplasms of lymphoid tissue from B lymphocytes
