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RNSG 1343 Leukemia
White blood cell disorders/ Leukemia
| Question | Answer |
|---|---|
| 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
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