Chapter 32: Caring for Clients with Disorders of the Lymphatic System

A nurse is preparing health education for a client who has received a diagnosis of myelodysplastic syndrome (MDS). Which of the following topics should the nurse prioritize?

Emergency management of bleeding episodes

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 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 public health nurse is planning community teaching for a group of older adults regarding aging and hematological conditions. What condition will the nurse identify as most common among this population?

Anemia

A client with Hodgkin's disease is hospitalized and experiencing respiratory distress. In which position should the nurse place the client?

High Fowler's

A nurse practitioner is assessing a client who has a fever, malaise, and a white blood cell count that is elevated. What principle should guide the nurse's management of the client's care?

Infection is the most likely cause of the client's change in health status.

A client who is undergoing chemotherapy for AML reports pain in the low back. What is the nurse's first action?

Assess renal function.

A client who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this client's needs for physical activity?

Assist the client to a chair during awake times, as tolerated.

A nurse is helping to prepare a client with lymphedema for a procedure in which an intravenous dye and radiography will be used to detect lymph node involvement and reveal the degree and extent of blockage in the lymph system. What procedure will the client be undergoing?

Lymphangiography

A 16-year-old girl has been brought to her primary care provider by her mother due to the daughter's recent malaise and lethargy. Which of the following assessments should the clinician perform in an effort to confirm or rule out infectious mononucleosis?

Palpating the patient's lymph nodes

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 is caring for a client who has been diagnosed with leukemia. The nurse's most recent assessment reveals the presence of ecchymoses on the client's sacral area and petechiae on the forearms. In addition to informing the client's primary care provider, the nurse should perform what action?

Check the client's most recent platelet level.

A nurse is planning the care of a client who has been admitted to the medical unit with a diagnosis of multiple myeloma. In the client's care plan, the nurse has identified a diagnosis of Risk for Injury, which should be attributed to what factor?

Decreased bone density

Which patient assessed by the nurse is most likely to develop myelodysplastic syndrome (MDS)?

A 72-year-old patient with a history of cancer

A 70-year-old client has recently been diagnosed with lymphoma and asks what may have contributed to this illness. Which of the following statements from the nurse would be most accurate?

"Lymphoma incidence increases with age because of cumulative exposures to carcinogens and a decline in immune functioning."

A nurse is documenting skin findings in a client with lymphedema. Which of the following descriptions would be most consistent with the expected presentation?

Brawny

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

When assessing a female client with a disorder of the hematopoietic or the lymphatic system, which assessment is most essential?

Health history, such as bleeding, fatigue, or fainting

A home health nurse is caring for a client with multiple myeloma. What intervention should the nurse prioritize when addressing the client's severe bone pain?

Helping the client manage the opioid analgesic regimen

A client is recovering from infectious mononucleosis. For which of the following conditions is the nurse aware that the client may also be at increased future risk?

Hodgkin's lymphoma

An oncology nurse is caring for a client with multiple myeloma who is experiencing bone destruction. When reviewing the client's most recent blood tests, the nurse should anticipate what imbalance?

Hypercalcemia

A client has completed the full course of treatment for acute lymphocytic leukemia and has failed to respond appreciably. When preparing for the client's subsequent care, the nurse should perform what action?

Identify the client's specific wishes around end-of-life care.

An older adult client is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL). What assessment finding is certain to be present if the client has CLL?

Increased lymphocyte 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 Not participating in a clinical trial Taking medication independent of meals Low socioeconomic status

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

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

An adult client's abnormal complete blood count (FBC) and physical assessment have prompted the primary care provider to order a diagnostic workup for Hodgkin lymphoma. The presence of what assessment finding is considered diagnostic of the disease?

Reed-Sternberg cells

The nurse is reviewing the chart of a client with lymphoma. Which of the following findings would best indicate to the nurse that the client has Hodgkin's disease as opposed to non-Hodgkin's lymphoma?

Reed-Sternberg cells are found diagnostically.

A client hospitalized with Hodgkin's disease is currently under visitor restrictions and asks the nurse why this is necessary. Which of the following explanations from the nurse is most accurate?

Restricting visitors and personnel reduces the risk of transmission of pathogens to the client.

A nurse is planning the care of client who has been diagnosed with essential thrombocythemia (ET). What nursing diagnosis should the nurse prioritize when choosing interventions?

Risk for Ineffective Tissue Perfusion

Laboratory and diagnostic test results have returned for a client with suspected lymphangitis. Which of the following would be most likely for the nurse to review in the results?

Streptococcus

A client with a myelodysplastic syndrome is being treated on the medical unit. What assessment finding should prompt the nurse to contact the client's primary care provider?

The client has an oral temperature of 37.5ºC (99.5ºF).

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 home care nurse is caring for a client with multiple myeloma. Which nursing interventions are appropriate for this client? Select all that apply.

The nurse delays position changes and bathing if the client is experiencing pain. The nurse instructs the client to avoid activities that may cause injury.

A teenage client presents with severe fatigue, sore throat, headache, oozing tonsils, and cervical lymph node enlargement. Which accessory lymphatic structure could enlarge?

lymph nodes

Which term refers to a form of white blood cell involved in immune response?

lymphocyte

A client presents with weeping lower extremity edema and skin that is thickened and brawny. This condition has been present for 4 weeks. The physician would likely order:

symptomatic treatment.

A young adult is preparing to begin treatment for non-Hodgkin lymphoma (NHL), a disease that has disseminated widely. What is the most likely treatment regimen for this patient that the nurse will help prepare?

Radiation and chemotherapy

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 at the health care facility is diagnosed with Hodgkin's disease that has extended to the liver. What stage should the nurse use to describe the progress of the disease?

Stage IV

A nurse is having a discussion with a group of 14-year-old camp counselors about how infectious mononucleosis is transmitted. This disease is transmitted by:

contact with the saliva of an infected person.

A client who has Hodgkin's disease should have their bed in high-Fowler's position whenever practical to:

increase lung expansion.