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RNSG 1343 Leukemia

White blood cell disorders/ Leukemia

Leukemia Ratio of red to white blood cells is reversed
Characteristics of Leukemia – Replacement of bone marrow by malignant immature WBCs – Abnormal immature circulating WBCs – Infiltration of these cells into the liver, spleen, and lymph nodes
WBCs arise from three different precursor cells – Myeloblasts– Monoblasts– Lymphoblasts
– Myeloblasts • Granular leukocytes (granuloctyes) • Neutrophils • Eosinophils • Basophils
– Monoblasts • Monocytes • Macrophages
– Lymphoblasts • Lymphocytes • B cells • T cells
• Leukemia results in severe anemia, infection, bleeding
• Manifestations of Leukemia – Pain – Tissue swelling – Headache – Alteration in level of consciousness – Cranial nerve impairment – Nausea
• Manifestations of Leukemia – Vomiting – Renal failure – Heat intolerance – Weight loss – Dyspnea on exertion – Tachycardia
• Risk factors for Leukemia – Cigarette smoking – Chemicals such as benzene – Exposure to ionizing radiation
• Leukemias are classified by acuity and the predominant cell type involved
• Acute myeloid leukemia – Uncontrolled proliferation of myeloblasts/hyperplasia of bone marrow/spleen – Manifestations result from neutropenia and thrombocytopenia.
• Chronic myeloid leukemia – Abnormal proliferation of all bone marrow elements – Associated with chromosome abnormality called Philadelphia chromosome – Asymptomatic in early stages – Terminal blast crisis phase
• Acute lymphocytic leukemia – Most common leukemia in children/young adults – Genetic factors may play role. – Malignant transformation of B cells – Onset is rapid.
• Chronic lymphocytic leukemia – Proliferation/accumulation of small, abnormal, mature lymphocytes in bone marrow, peripheral blood, body tissues
• Manifestations of Chronic lymphocytic leukemia • Anemia • Infection • Enlarged lymph nodes • Splenomegaly • Hepatomegaly
• Diagnostic tests for Leukemia – CBC with differential – Platelets – Bone marrow examination
• Chemotherapy – Single or combination chemotherapy – Post-remission chemotherapy administered to: • Eradicate additional leukemic cells • Prevent relapse • Prolong survival
• Radiation therapy – Damages cellular DNA so that cell cannot divide, multiply
– Allogeneic BMT • Bone marrow cells from donor • Closely matched
– Autologous BMT • Patient's own bone marrow • Also called bone marrow rescue • About 1L of bone marrow aspirated during a period of disease remission, then frozen to use during relapse
• Nursing Diagnoses for Leukemia – Risk for Infection – Imbalanced Nutrition: Less Than Body Requirements – Impaired Oral Mucous Membranes – Ineffective Protection
Created by: pdimple