Blood cancers

A nurse is teaching a client with multiple myeloma about the therapeutic benefits of radiation therapy. Which statements will the nurse include in the teaching? Select all that apply. "It helps to decrease bone pain." "It decreases excess calcium." "It decreases the bone malignancy." "It helps to activate an immune response." "It helps to strengthen the bone."

"It helps to strengthen the bone." "It helps to decrease bone pain."

The nurse is creating a plan of care for the client with multiple myeloma and includes which priority intervention in the plan? 1.Encouraging fluids 2.Providing frequent oral care 3.Coughing and deep breathing 4.Monitoring the red blood cell count

1.Encouraging fluids Hypercalcemia caused by bone destruction is a priority concern in the client with multiple myeloma. The nurse should administer fluids in adequate amounts to maintain a urine output of 1.5 to 2 L/day; this requires about 3 L of fluid intake per day. The fluid is needed not only to dilute the calcium overload but also to prevent protein from precipitating in the renal tubules.

The nurse is reviewing the record of a client admitted to the hospital with a diagnosis of Hodgkin's disease. Which assessment findings noted in the client's record are associated with this diagnosis? Select all that apply. 1.Fever 2.Weight loss 3.Night sweats 4.Visual changes 5.Enlarged, painless lymph nodes

1.Fever 2.Weight loss 3.Night sweats 5.Enlarged, painless lymph nodes

A client is being evaluated for a diagnosis of chronic myeloid leukemia (CML). What diagnostic indicator will the nurse assess? A leukocyte count >100,000/mm3 Lymphadenopathy Increased number of blast cells An enlarged liver

A leukocyte count >100,000/mm3 Although there is an increase in the production of blast cells and the client may have an enlarged liver and tender spleen, it is the high leukocyte count that is diagnostic

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action? Administer pain medication, as ordered. Assess renal function. Place heating pads on the client's back. Refer the client to a chiropractor.

Assess renal function.

A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention? Assess the client's skin. Assess the client's pulse and blood pressure. Assess the client's hemoglobin and platelets. Check the client's history.

Assess the client's hemoglobin and platelets.

An elderly client is hospitalized for induction of chemotherapy to treat leukemia. The client reports fatigue to the nurse. What nursing intervention would best address the client's fatigue? Assist the client to sit in a chair for meals. Provide sedentary activities only, such as watching television. Have the client maintain complete bedrest. Talk to the family about not visiting so the client can obtain rest.

Assist the client to sit in a chair for meals.

The nurse is reviewing the long-term treatment plan with a client diagnosed with Hodgkin lymphoma. Which recommendations will the nurse provide to reduce the client's risk of developing secondary malignancies? Select all that apply. Reduce intake of alcohol. Restrict use of tobacco. Limit the intake of citrus fruits. Avoid foods high in carbohydrates. Avoid excessive sunlight.

Avoid excessive sunlight. Restrict use of tobacco. Reduce intake of alcohol.

A client with a new onset of rib and spine pain is being evaluated for multiple myeloma. For which manifestations will the nurse assess this client? Select all that apply. Lymph enlargement Bone destructions Renal dysfunction Anemia Hypercalcemia

Bone destructions Renal dysfunction Anemia Hypercalcemia

A client is being tested for acute myeloid leukemia (AML). The nurse knows that which diagnostic test will be used as the hallmark for the diagnosis? Complete blood count Clotting factors Alkaline phosphatase level Bone marrow analysis

Bone marrow analysis

The nurse suspects that a client has multiple myeloma based on the client's major presenting symptom and the analysis of laboratory results. What classic symptom for multiple myeloma does the nurse assess for? Gradual muscle paralysis Debilitating fatigue Severe thrombocytopenia Bone pain in the back of the ribs

Bone pain in the back of the ribs Although patients can have asymptomatic bone involvement, the most common presenting symptom of multiple myeloma is bone pain, usually in the back or ribs. Unlike arthritic pain, the bone pain associated with myeloma increases with movement and decreases with rest; clients may report that they have less pain on awakening but the pain intensity increases during the day.

A client is receiving radiation therapy for lesions in the abdomen from non-Hodgkin's lymphoma. Because of the effects of the radiation treatments, what will the nurse assess for? Diarrheal stools Adventitious lung sounds Laryngeal edema Hair loss

Diarrheal stools

The nurse is caring for a client with chronic myeloid leukemia (CML). The nurse knows that which symptoms indicate the client is in the accelerated phase of the condition? Select all that apply. Dyspnea Fatigue Bone pain Splenomegaly Confusion

Dyspnea Fatigue Bone pain Splenomegaly

A nurse prepares a client for a bone marrow biopsy who is suspected of having acute myeloid leukemia. What results from the bone marrow biopsy does the nurse expect? Excess of immature erythrocytes Deficiency of erythrocytes Excess of immature leukocytes Deficiency of neutrophils

Excess of immature leukocytes

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 Chronic myeloid leukemia Non-Hodgkin lymphoma Hodgkin lymphoma

Multiple myeloma

A client is awaiting test results to diagnose Hodgkin lymphoma. The nurse knows that which result is the hallmark for the diagnosis of this condition? Elevated platelet count Misshaped red blood cells Increased basophils Reed-Sternberg cells

Reed-Sternberg cells

A client with suspected multiple myeloma is reporting back pain. What is the priority nursing action? Have the client rest. Have the client lie on a hard surface. Encourage ambulation. Send the client for a spinal x-ray study.

Send the client for a spinal x-ray study. The client with myeloma can have bone pain, especially in the back and ribs. The pain will decrease with rest and increase with activity. Lying on a hard surface will not relieve the pain. The priority action is to make certain the client does not have a fractured spine, as the bone destruction in this disease is sufficiently severe to cause vertebral collapse.

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? Platelet count 300,000/mm3 Serum sodium level of 133 mEq/L Serum calcium level 13.8 mg/dl Hemoglobin of 9.8 g/dl

Serum calcium level 13.8 mg/dl

The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma? The client with a painful sore throat. The client with painful lymph nodes in the groin. The client with painful lymph nodes under the arm. The client with enlarged lymph nodes in the neck.

The client with enlarged lymph nodes in the neck.

The nurse in the oncology clinic is caring for a 42-year-old female client receiving chemotherapy with fludarabine for acute myeloid leukemia who has developed petechiae, epistaxis, and ecchymosis. The nurse anticipates that the client has developed (hemorrhge, DVT, infection, hyperkalemia ) and that the laboratory results will reveal (thrombocytopenia, leukocytosis, abnormal renal function, electrolyte imbalance)

hemorrhage, thrombocytopenia

The nurse is reviewing the laboratory results of a client diagnosed with multiple myeloma. Which would the nurse expect to note specifically in this disorder? 1.Increased calcium level 2.Increased white blood cells 3.Decreased blood urea nitrogen level 4.Decreased number of plasma cells in the bone marrow

1.Increased calcium level Findings indicative of multiple myeloma are an increased number of plasma cells in the bone marrow, anemia, hypercalcemia caused by the release of calcium from the deteriorating bone tissue, and an elevated blood urea nitrogen level. An increased white blood cell count may or may not be present and is not related specifically to multiple myeloma.

A nurse on an oncology unit is providing discharge teaching to an adolescent female client who received a bone marrow transplant for leukemia. Which of the following pieces of information should the nurse include in the teaching? (Select all that apply.) A. "Take your temperature twice each day." B. "You may return to school if you feel strong enough." C. "It is important to wear shoes always." D. "Clean your toothbrush weekly with isopropyl alcohol." E. "Avoid using tampons."

A. "Take your temperature twice each day. C. "It is important to wear shoes always." E. "Avoid using tampons."

The nurse tells a client with leukemia who is receiving chemotherapy that allopurinol has been added to the medication list. When the client asks the purpose of the new medication, the nurse responds that the allopurinol is intended to prevent which problem? 1.Nausea 2.Diarrhea 3.Muscle spasms 4.Hyperuricemia

Hyperuricemia Chemotherapy destroys cells, leading to the release of uric acid into the bloodstream. The client is then at risk of experiencing uric acid nephropathy, renal stones, and acute kidney injury. Allopurinol, an antigout medication, is used with chemotherapy to prevent or treat this complication of therapy

The nurse is reviewing the medical record for a client who has been diagnosed with Hodgkin's disease. The nurse should check which diagnostic test noted in the client's record to determine the stage of the disease? 1.Blood studies 2.Bone marrow examination 3.Excisional lymph node biopsy 4.Positron emission topography (PET) scan

Positron emission topography (PET) scan Hodgkin's disease is a chronic progressive neoplastic disorder of lymphoid tissue. It is characterized by painless enlargement of lymph nodes with progression to extralymphatic sites, such as the spleen and liver. Diagnostic testing for this disorder includes blood studies, excisional lymph node biopsy, bone marrow examination, and radiographic studies. These tests are used for evaluation purpose but are not definitive. PET scan with or without computed tomography is used to diagnose and determine the stage of the disease.

A client is newly diagnosed with Hodgkin lymphoma. The nurse understands that the client's treatment will be based on what concept? Histology of tissue Involvement of lymph nodes Total blood cell count Staging of disease

Staging of disease

The nurse is conducting a history and monitoring laboratory values on a client with multiple myeloma. What assessment findings should the nurse expect to note? Select all that apply. 1.Pathological fracture 2.Hemoglobin level of 15.5 g/dL (155 mmol/L) 3.Calcium level of 8.6 mg/dL (2.15 mmol/L) 4.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L)

1.Pathological fracture 4.Serum creatinine level of 2.0 mg/dL (176.6 mcmol/L) Multiple myeloma is a B cell neoplastic condition characterized by abnormal malignant proliferation of plasma cells and the accumulation of mature plasma cells in the bone marrow. The client with multiple myeloma may experience pathological fractures, hypercalcemia, anemia, recurrent infections, and renal failure.

Which precautions should a nurse include in the care plan for a client with leukemia and neutropenia? Provide a clear liquid, low-sodium diet. Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing. Put on a mask, gown, and gloves when entering the client's room. Have the client use a soft toothbrush and electric razor, avoid using enemas, and watch for signs of bleeding.

Eliminate fresh fruits and vegetables, avoid using enemas, and practice frequent hand washing.

n which of the following diseases would bone marrow transplantation not be indicated in a newly diagnosed client? A. Severe aplastic anemia B. Severe combined immunodeficiency C. Acute lymphocytic leukemia D. Chronic myeloid leukemia

C. Acute lymphocytic leukemia Option C: For the first episode of acute lymphocytic leukemia, conventional therapy is superior to bone marrow transplantation. Treatment is usually long-term chemotherapy and is composed of 3 phases (induction, consolidation, and maintenance).