Ch. 30 Management of Patients with Hematologic Neoplasms
The nurse is teaching a client about the development of leukemia. What statement should be included in the teaching plan?
"Chronic leukemia develops slowly."
A client presents with peripheral neuropathy and hypoesthesia of the feet. What is the best nursing intervention?
Assess for signs of injury.
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?
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?
Bone pain in the back of the ribs
The nurse is assessing a client experiencing symptoms of non-Hodgkin lymphoma with a suspected mediastinal mass. The nurse knows that which assessment findings would indicate this complication? Select all that apply.
Cough Chest pain Shortness of breath
A patient with acute myeloid leukemia (AML) is having hematopoietic stem cell transplantation (HSCT) with radiation therapy. In which complication do the donor's lymphocytes recognize the patient's body as foreign and set up reactions to attack the foreign host?
Graft-versus-host disease
A nurse is caring for a client with multiple myeloma. Which laboratory value is the nurse most likely to see?
Hypercalcemia
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
Which term refers to a form of white blood cell involved in immune response?
Lymphocyte
A client has completed induction therapy and has diarrhea and severe mucositis. What is the appropriate nursing goal?
Maintain nutrition.
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
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 assessment finding best indicates that the client has recovered from induction therapy?
Neutrophil and platelet counts within normal limits
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.
Which term refers to an abnormal decrease in white blood cells, red blood cells, and platelets?
Pancytopenia
Clients with multiple myeloma have abnormal plasma cells that proliferate in the bone marrow where they release osteoclast-activating factor, resulting in the formation of osteoclasts. What is the most common complication of the pathology resulting from this process?
Pathologic fractures
The hospitalized client is experiencing gastrointestinal bleeding with a platelets at 9,000/mm³. The client is receiving prednisone and azathioprine. What action will the nurse take?
Perform a neurologic assessment with vital signs.
A client is diagnosed with low risk asymptomatic polycythemia vera. For which treatment will the nurse prepare teaching for this client?
Phlebotomy
The nurse is performing an assessment on a patient with acute myeloid leukemia (AML) and observes multiple areas of ecchymosis and petechiae. What laboratory study should the nurse be concerned about?
Platelet count of 9,000/mm3
The nurse recognizes the clinical assessment of a patient with acute myeloid leukemia (AML) includes observing for signs of infection early. What nursing action will most likely help prevent infection?
Practice vigilant handwashing.
A nurse is caring for a client with multiple myeloma. Which nursing intervention is most appropriate for this client?
Preventing bone injury
The nurse is assisting the client with multiple myeloma to ambulate. What is the most important nursing intervention to help prevent fractures in the client?
Promote safety.
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?
Reed-Sternberg cells
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
A client is newly diagnosed with Hodgkin lymphoma. The nurse understands that the client's treatment will be based on what concept?
Staging of disease
The nurse is assessing several clients. Which client does the nurse determine is most likely to have Hodgkin lymphoma?
The client with enlarged lymph nodes in the neck.
A client with polycythemia vera reports gouty arthritis symptoms in the toes and fingers. What is the nurse's best understanding of the pathophysiological reason for this symptom?
The dead red blood cells release excess uric acid.
Which statement best describes the function of stem cells in the bone marrow?
They produce all blood cells.
The nurse is caring for a client with acute lymphocytic leukemia (ALL) who is Philadephia chromosome negative. Which medications will the nurse anticipate providing to the client during initiation of pharmacological therapies? Select all that apply.
Vincristine Dexamethasone
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.
hemorrhage thrombocytopenia
A nurse is assessing a client with multiple myeloma. Due to this condition, what will this client be at risk for?
pathologic bone fractures.
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
