Hematologic Cancer

ANC

Absolute Neutrophil Count

When caring for a patient with multiple myeloma, the nurse should take appropriate precautions to A. alleviate respiratory difficulty. B. prevent fractures. C. prevent seizures. D. alleviate diarrhea.

B

A client with thrombocytopenia, secondary to leukemia, develops epistaxis (nose bleeding). The nurse should instruct the client to: A. lie supine with his neck extended. B. sit upright, leaning slightly forward. C. blow his nose and then put lateral pressure on his nose. D. hold his nose while bending forward at the waist.

B is correct: The upright position, leaning slightly forward, avoids increasing the vascular pressure in the nose and helps the client avoid aspirating blood. Lying supine won't prevent aspiration of the blood. Nose blowing can dislodge any clotting that has occurred. Bending at the waist increases vascular pressure in the nose and promotes bleeding rather than halting it.

What blood cells come from the lymphoid family

B lymphocytes, T lymphocytes, Natural killer cells

Multiple drugs are used in combination to treat leukemia and lymphoma because A. the chance that one of the drugs will be effective is increased. B. drug resistance is likely to be increased with combination therapy. C. the drugs will interrupt cell growth and division at multiple points in the cell cycle. D. patients are likely to develop drug toxicity to some of the drugs.

C

Staging of Hodgkin's or Non-Hodgkin's Lymphoma includes identification of "B Symptoms." B symptoms include: A. hepatomegaly, fever, thrombocytopenia. B. weight loss, anemia, fatigue C. fever, night sweats, weight loss. D. night sweats, fatigue, painless lymph node involvement

C

Panculture

Culture everything

A nurse is reviewing the laboratory report of a client who underwent a bone marrow biopsy. The finding that would most strongly support a diagnosis of acute leukemia is the presence of a large number of immature: A. monocytes. B. thrombocytes. C. basophils. D. leukocytes.

D Leukemia is manifested by an abnormal overproduction of immature leukocytes in the bone marrow. An increased # of monocytes may result from a viral infection. An increased # of basophils may result from an allergic reaction.

Signs of sepsis include VS changes of _______ BP and _________ HR along with _________ oxygen needs

Decreased BP Increased HR Increased Oxygen Needs

What are B Symptoms

Fever Unexplained weight loss Night sweats

Filgrastim

Granulocyte colony-stimulating factor Helps to create more WBC in neutropenic patients

Sargramostim

Granulocyte-macrophage colony-stimulating factor Helps create more WBCs in neutropenic patients

What disease do we see B symptoms with

Hodgkins lymphoma

Hodgkins VS Non-Hodgkins Lymphoma

Hodgkins- Reed-Sternberg cells affected (type of B cells) Non-Hodgkins Lymphoma- No involvement of Reed-Sternberg cells

Indolent

Low grade (symptoms)

With what disease is Benc Jones protein found in the urine?

Multiple Myeloma

Neutropenia VS Leukopenia

Neutropenia- low number of neutrophils Leukopenia- low number of all WBCs

What blood cells come from the myeloid family

RBC, Platelets, Eosinophils, Basophils, and Neutrophils

What do B Symptoms indicate?

Systemic involvement

What does ANC determine

The severity of Neutropenia

What is the highest ANC still considered Neutropenia?

1,500 cells/mm^3