16 b wbc

Question 1

The cell cycle and cytotoxic drugs

Answer 1

 All cells-normal and neoplastic-must go
through cell division.
 Toxic to all dividing cells.
 Classified according to mechanism of
action during the cell cycle

Question 2

Cell cycle-specific drugs

 Cell cycle non-specific drugs

Answer 2

exert their action
during certain phases of cell division.
act on tumour
cells in both resting & dividing phases.

Question 3

Treatment

Phases of therapy leukaemia

Answer 3

 Induction  Consolidation  Maintenance

Question 4

Nursing Management leukaemia

Answer 4

◦ Drug calculations for Body Surface Area
◦ Be aware of drug side-effects and interactions
◦ Symptom and side effect management
◦ Check pathology results for need for neutropenic precautions, blood
transfusions, electrolyte replacement
◦ Perform line care of CVAD
◦ Patient education
◦ Refer to interdisciplinary team
◦ Long term management

Question 5

Patient teaching leukaemia

Answer 5

o Handwashing importance and technique
o Care of skin; use lotion to keep skin supple and intact. Avoid activities that could result in cuts or scratches on the skin, such as
using a razor blade or gardening without gloves.
o Instruct the patient to avoid crowds and anyone with known sickness.
o Signs and symptoms of an infection to report promptly to the health care provider. Report fever of 38°C or higher; chills; cough;
SOB; white patches in the mouth; sore throat; swollen glands; burning upon urination or offensive urine; persistent diarrhoea; any
sores or lesions that have redness, swelling and drainage; and extreme fatigue. Instruct the patient to monitor the temperature
daily because fever may be the only presenting symptom.
o Instruct the patient to avoid fresh flowers, fruits, and vegetables.
o Cook food properly to kill bacteria and to refrigerate leftovers immediately.
o Instruct the family to keep the bathroom and kitchen clean and disinfected on a daily basis to decrease bacteria. Instruct the
patient and family to properly clean and disinfect all eating utensils and dishes.
o Instruct the patient to avoid pets, scratches etc.
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3.Leukopaenia
 Decrease in the number of white cells in the blood

Question 6

Leukopaenia

Answer 6

 Decrease in the number of white cells in the blood (often called neutropenia)
 Increased risk of infection
 Often drug induced (chemotherapy, steroids) but can also be caused by typhoid fever, HIV/AIDS, influenza

Question 7

4. Lymphadenopathy

Answer 7

 Enlarged lymph nodes, caused by the increase
in size and number of lymphocytes or invasion
by malignant cells
 Localised lymphadenopathy usually indicates
drainage of an area associated with
inflammatory or infectious lesion

Question 8

Lymphadenopathy caused by

Answer 8

Immunological or inflammatory conditions 
Endocrine disorders 
Of unknown cause – such as reactions to
drugs, and autoimmune disease 
Neoplastic disease

Question 9

Lymphoma

Answer 9

 Lymphoma is a cancer primarily of the lymph
nodes. There are two main types:
 Hodgkin’s Lymphoma (HL)
 Non-Hodgkin lymphoma (NHL)
 Originates in bone marrow and lymphatic
structures, resulting in the proliferation of
lymphocytes

Question 10

Hodgkin's Lymphoma (HL)
cellular origin
extent of disease
b symptoms
extranodal involvement

Answer 10

b lymphocyte
localised to regional, but may be more widspread
common
rare

Question 11

Non-Hodgkin lymphoma (NHL)
cellular origin
extent of disease
b symptoms
extranodal involvement

Answer 11

b lymphocyte (85%)
t or natural killer lymphocyte (15%)
disseminated
40%
common