PrepU | Assignment 11 | Chapter 30: Management of Patients with Hematologic Neoplasms
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 patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)?
A 72-year-old patient with a history of cancer
Which of the following are complications related to polycythemia vera (PV)? Select all that apply.
CVA MI Ulcers Hematuria
A nurse cares for a client with early Hodgkin lymphoma. While assessing the client, the nurse will most likely find painless enlargement of which lymph node?
Cervical
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
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
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 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
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.
A client being treated for non-Hodgkin lymphoma asks the nurse why they need to be monitored for additional forms of leukemia. Which is the nurse's best response?
"These are seen among survivors like yourself."
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
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.
The nurse is teaching the client about consolidation. What statement should be included in the teaching plan?
"Consolidation therapy is administered to reduce the chance of leukemia recurrence."
The nurse is interacting with a family that has been caring for a client with cancer for several months. What are the best interventions to assist in relieving caregiver stress in this family? Select all that apply.
Educate the family about medications and side effects. Allow family members to express feelings. Suggest support for household maintenance.
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
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 is teaching a client about the development of leukemia. What statement should be included in the teaching plan?
"Chronic leukemia develops slowly."
The nurse is caring for a client with acute myeloid leukemia (AML) with high uric acid levels. What medication does the nurse anticipate administering that will prevent crystallization of uric acid and stone formation?
Allopurinol
A client presents with peripheral neuropathy and hypoesthesia of the feet. What is the best nursing intervention?
Assess for signs of injury.
A client with AML has pale mucous membranes and bruises on the legs. What is the primary nursing intervention?
Assess the client's hemoglobin and platelets.
A client with Hodgkin lymphoma is planning to receive the Stanford V treatment protocol. Which medication teaching will the nurse prepare for this client? Select all that apply.
Etoposide Vinblastine Doxorubicin Mechlorethamine
A client who is being treated for AML has bruises on both legs. What is the nurse's most appropriate action?
Evaluate the client's platelet count.
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
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 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 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 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.
Which statement best describes the function of stem cells in the bone marrow?
They produce all blood cells.
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
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
A nurse plans care for a client with multiple myeloma. Using the CRAB acronym for symptoms associated with this disease, which clinical features does the nurse expect to find upon assessment of the client? Select all that apply.
Hypercalcemia Renal insufficiency Anemia Bone lesions
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
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 assessing a client admitted with a deep vein thrombosis with an elevated red blood cell count. The admitting diagnosis is polycythemia vera. What is the hallmark clinical sign of PV?
splenomegaly
The clinic nurse is caring for a client diagnosed with leukopenia. What does the nurse know this client has?
A general reduction in all white blood cells
What assessment finding best indicates that the client has recovered from induction therapy?
Neutrophil and platelet counts within normal limits
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
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 (SOB)