3613 Blood Cancers/Leukemia

A patient newly diagnosed with leukemia presents to the clinic for the first chemotherapy session. The patient states, "This disease won't defeat me. It will not interrupt my life." Which statement by the nurse is most appropriate? "I think that's great! A positive attitude is half the battle." "Don't be so sure. Leukemia treatment is extremely stressful." "Yes, leukemia therapy is pretty straightforward." "Although your response to treatment is unknown right now, you have a good outlook."

"Although your response to treatment is unknown right now, you have a good outlook."

A patient with leukemia asks why he has to take extra precautions against infection. What is the best response by the nurse? "Leukemia puts you at risk for anemia." "There is no clear etiology for risk of infection." "Your white blood cells are infiltrating your organs." "Bone marrow failure can result in decreased white blood cells."

"Bone marrow failure can result in decreased white blood cells."

The nurse is preparing to provide patient and family education to a patient with multiple myeloma who will be discharged the following day. Which is the most appropriate teaching to ensure patient safety after discharge? "Ensure adequate support when walking." "Make sure you take the prescribed analgesics." "Drink plenty of water every day." "Have electrolytes monitored frequently." NOT SURE

"Ensure adequate support when walking."

A nurse is educating the patient on the appropriate treatment for Hodgkin's lymphoma. Which statement by the patient indicates the need for further teaching? Select all that apply. "I will be able to stop my treatment once the cancer is in remission." "We can start with a conservative treatment of corticosteroids and see how I respond." "The treatment for the disease is safe and without serious side effects." "The treatment for my cancer will depend on the stage at which I am diagnosed." "Chemotherapy is the only treatment for Hodgkin's lymphoma."

"I will be able to stop my treatment once the cancer is in remission." "We can start with a conservative treatment of corticosteroids and see how I respond." "The treatment for the disease is safe and without serious side effects." "Chemotherapy is the only treatment for Hodgkin's lymphoma."

The nurse is caring for a patient newly diagnosed with Hodgkin's lymphoma. Which statement by the patient indicates to the nurse that further education on the disease's etiology is needed? "I've gotten a lot of viruses." "I work around a lot of toxins at work." "I once had an Epstein-Barr infection." "My aunt and grandmother had Hodgkin's too."

"I've gotten a lot of viruses."

A patient questions a new diagnosis of chronic myelogenous leukemia (CML) because he has no symptoms. Which response by the nurse is appropriate? "Some patients may not ever have symptoms with CLL." "It's very common for patients with CLL to have no symptoms initially." "You did have symptoms; you probably just thought it was weakness or fatigue." "Your symptoms were disguised because you were battling the flu at that time, too."

"It's very common for patients with CLL to have no symptoms initially."

A woman with Hodgkin's lymphoma is receiving patient education from the nurse. Which recommendation for follow-up care is important to prevent future malignancies? "Make sure you have routine mammograms." "Continue to have yearly positron emission tomography (PET) scans." "A bone marrow examination should be performed routinely." "A complete blood count (CBC) should be done at every follow-up appointment." NOT SURE

"Make sure you have routine mammograms."

A patient with multiple myeloma asks the nurse why this disease developed. Which statement is the best response by the nurse regarding the cause for multiple myeloma? "The cause and risk factors for multiple myeloma are unknown and under debate." "Hypercalcemia leads to bone degeneration and multiple myeloma." "The etiology is unknown, but risk factors include skeletal fractures, family history, and chemical exposure." "There is no primary cause for multiple myeloma, but some risk factors, such as radiation and obesity, are associated with the disease."

"There is no primary cause for multiple myeloma, but some risk factors, such as radiation and obesity, are associated with the disease."

Why are the types of leukemia

ALL AML CLL CML

Which interventions will the nurse include in the plan of care for a patient admitted for hematopoietic stem cell transplantation (HSCT) to treat acute lymphocytic leukemia (ALL)? Select all that apply. Bring a DVD player in to the patient's room so the patient can watch movies. Educate the patient regarding graft-versus-host disease (GVHD). Provide information and brochures about hospice care. Ask the patient about religious preferences and whether the patient would like the chaplain to visit. Have the patient turn, take a deep breath, and use an incentive spirometer every 1 to 2 hours.

Bring a DVD player in to the patient's room so the patient can watch movies. Educate the patient regarding graft-versus-host disease (GVHD). Ask the patient about religious preferences and whether the patient would like the chaplain to visit. Have the patient turn, take a deep breath, and use an incentive spirometer every 1 to 2 hours. .

What type of leukemia are children least likely to get

CML

What type of leukemia has an increased number of banded neutrophils

CML

What type of leukemia usually doesn't show show symptoms in the early stages?

CML

Types of remission

Complete- no evidence of overt disease on physical examination, bone marrow and peripheral blood appear normal. partial- characterized by lack of symptoms, and normal blood smear, but evidence of disease in bone marrow Molecular- complete remission with no evidence of disease in the blood cells and/or bone marrow using sensitive PCR tests. ( this test is most common in clinical trials) studies are negative for residual leukemia. Disease is decreased to the point where it is no longer detectible.

A patient has undergone radiation therapy for leukemia. Which assessments should the nurse complete to determine whether a patient has experienced adverse effects of this therapy? Take vital signs. Perform a retinal examination. Measure urine output. Examine skin color and appearance.

Examine skin color and appearance.

Visitors carrying a vase of flowers approach the room of a leukemia with leukemia for whom neutropenia precautions have been implemented. Which is the most appropriate action by the nurse before allowing the guests to enter the patient's room? Stopping the visitors and introducing himself/herself. Instructing the visitors to leave the vase of flowers at the nurses' station. Telling the visitors to limit their visit to 60 minutes. Telling the visitors that only two of them should be in the room at one time.

Instructing the visitors to leave the vase of flowers at the nurses' station.

Documentation reveals a patient's lymph nodes are abnormal and indicative of Reed-Sternberg cells. When the nurse is reviewing the patient's medical history, which finding is likely? Mononucleosis infection 10 years ago Repeated radiation exposure Hip fracture from a fall and osteoporosis Presence of the Philadelphia chromosome

Mononucleosis infection 10 years ago

Which collaborative care treatment modality should the nurse include in the plan of care to prevent complications for the patient with multiple myeloma? Prescribe weight-bearing exercises with physical therapy. Have the nuclear medicine department perform routine positron emission tomography (PET) scans. Arrange for radiation treatments. Have the pharmacist explain the chemotherapy drugs to the patient.

Prescribe weight-bearing exercises with physical therapy.

Risk factors for leukemia

Radiation Smoking Benzene Chemotherapy Family History

The nurse is caring for a patient with advanced multiple myeloma. Which action by the nurse is appropriate to meet the goals of collaborative care for this patient? Draw blood for laboratory tests. Educate patient on bone marrow examination. Provide emotional support to the patient. Review patient's analgesia administration record.

Review patient's analgesia administration record.

A patient with Hodgkin's lymphoma has been receiving chemotherapy for several months. Aside from managing chemotherapy side effects, which is the most appropriate intervention to be included in the patient's plan of care? Recommend appropriate rehabilitation resources once chemotherapy ends. Suggest alternative therapies to replace the chemotherapy. Support the patient by providing resources for optimal psychosocial health. Have the patient adhere to a strict dietary pattern to ensure adequate caloric intake.

Support the patient by providing resources for optimal psychosocial health.

A nurse is educating a patient who has recently been diagnosed with Hodgkin's lymphoma. The nurse explains which signs/symptoms may be experienced if the disease is in the advanced stage? Select all that apply. Urinary symptoms Loss of motor function Increased intracranial pressure Decreased red blood cell levels Painless cervical node swelling

Urinary symptoms Loss of motor function Decreased red blood cell levels

A nurse is caring for a patient with multiple myeloma who is experiencing significant skeletal pain. The patient expresses an interest in nonpharmacological pain relief. About which therapy would the nurse provide the patient more information? Chemotherapy Ambulation Watchful waiting Use of a back brace

Use of a back brace

The nurse is reviewing the laboratory results of a patient who received chemotherapy for acute myelogenous leukemia (AML). Which laboratory finding would compel the nurse take the grapes off the patient's lunch tray? Red blood cell count (RBC) of 3.2 cells/μL White blood cell count (WBC) of 1.6 cells/μL Platelet count of 100,000 cells/μL Blood urea nitrogen (BUN) of 30

White blood cell count (WBC) of 1.6 cells/μL

Chronic Myeloid Leukemia- CML-

affect myeloid cells - 55 and older, grows slowly at first, advanced age 65, very rare in children, connected with an abnormal chromosomes Philadelphia chromosome. Abnormality in 95% of patients with it. Symptoms are very obscure- may have symptoms for several years, or have it and no symptoms, low WBC counts, fatigue, bone pain, anorexia, frequent infections, chronic ML does not respond to treatment well so they don't achieve remission well, pain.

Where are leukemia cells found?

cancerous cells in spleen, bone marrow and lymphatic system

Chronic Lymphocytic Leukemia- CLL-

most common in adults, usually grows slowly and when you look at them under the microscope they look normal in the beginning most people with it are over the age of 65. Signs- enlarged lymph nodes throughout the body, If SS, enlarged lymph nodes, extraordinary fatigue, fever, night sweats, (Adults) more predominant in men.

Acute Lymphocytic (lymphoblastic) Leukemia- ALL-

most common type In children- 2-5 years old, adults after age 50. (quickly recognized, fast growing, quickly have symptoms, fever, pallor, tendency to bleed, bruising, petchia, bleeding under the skin. Purple dots under skin, loss of petite, bone pain, generalized lymphadenopathy- swollen lymph nodes, possible swelling of spleen and liver, CBC- all blood counts are low. Affects all blood cells, high liver enzymes, liver is trying to filter the blood, working hard and gets damaged. Bone pain because there is a lack of RBC's and thus lack of oxygen, so bones are not getting good blood supply and they flatten on the ends and they rub together so you get bone pain. 20-25% have Philadelphia chromosome.

Acute Myeloid Leukemia (AML)-

mostly adults, can affect children but mostly adults of advancing age, abrupt onset with serious infection or abnormal bleeding, fatigue, weakness, bleeding, bone marrow trying to work hard, sternum and long bones are painful because trying to replace lost bone cells, same type of lab values, All blood counts low and liver is high.

What factors affect the prognosis of leukemia

type of leukemia that they have age how much it has spread