Exam 2 - Buerger's, Raynaud's, and Leukemia Flashcards
Nursing education for Buerger’s disease
Autoimmune disease that affects men ages 20-40
Those who smoke are at biggest risk so teach to stop smoking
Pt education with Raynaud’s phenomenon
Wear gloves
Triggered by cold and stress
Don’t smoke
Medications for Raynaud’s phenomenon
Calcium channel blockers
Alpha blockers
Prescription skin creams
Less often - ACE inhibitors
Most common in young children, peak age for diagnosis is 4yo
Acute lymphoblastic leukemia
More common in older adults, peak age for diagnosis is 72yo
Chronic lymphocytic leukemia
Slow insidious onset, may not have any s/sx but have c/o fatigue, exercise intolerance, swollen lymph glands, enlarge spleen, edema, paleness, thrombophlebitis. Can also develop B symptoms - night sweats, fever, weight loss
Chrornic lymphocytic leukemia
Common in older adults
Associated with exposure to toxins, genetic disorders, and treatment of other cancers
S/sx - fatigue, weakness, fever, anemia, headache, bone and joint pain, recurrent infections, bruising, liver/spleen inflammation
Acute myeloid leukemia
Associated with Philadelphia chromosome (genetic)
Survival rate in “blast” phase is just months
Chronic myeloid leukemia
First phase of chemotherapy treatment
Induction - high doses to kill leukemic cells
Second phase of chemotherapy treatment
Consolidation - less strong doses to kill leukemic cells that are left behind
What is the main thing you should know about bone marrow transplants?
Must have a donor
Prior to transplant, person receiving has to do aggressive chemo and radiation
Pt is at high risk for infection, bleeding, and anemia so will be in hospital for 6-8 weeks in reverse isolation
Biggest issue in bone marrow transplants
Graft vs. host disease
What happens with graft vs. host disease?
When bone marrow is eradicated, person is very immunocmopromised and sometimes the transplant tissue mounts a reaction to the person’s body (it rejects the persons body). Can happen immediately or up to 100 days later
S/sx of graft vs. host disease
Rash on hands, soles of feet, may cover entire body
Break down of epithelial cells
Inside of GI tract starts to break down (including mouth)
What can be given to pt with graft vs. host?
Steroids to fight inflammation, immunosuppressant drugs to dampen response
What is a chemotherapy complication?
Tumor lysis syndrome - chemo destroys cells, K and Ph leak out so pt will have high K, low Ca, and high uric acid
Nursing considerations for pt who has had chemo or received a bone marrow transplant?
No flowers, no fresh plants
Give good oral care
Pay attention to c/o undue fatigue because first sign of infection could be a crash
No aspirin or OTC meds (NSAIDs, alka-seltzer) because interferes with platelet function
Don’t go into crowded, public places
Avoid fresh fruits and veggies
Report fever, chills, bleeding, bruising, painful urination, foul smelling discharge, skin lesions
Use electric razors
Do not insert anything that can cause damage to tissue or bleeding - suppositories, tampons, enemas
Provide teaching about treatments, support groups, and meds
How do you figure ANC?
(% neutrophils + % bands) x total WBC count
______________________________________
100
When are neutropenic precautions initiated?
ANC less than 1500 mm^3 = private room
