Hematological Disorders Flashcards
WHAT AM I:
- sudden on set of symptoms
- leukocytes are undifferentiated
- immature calls (blasts)
- progresses rapidly
- death can occur in weeks to months without rapid treatment.
- acute leukemia
What is this a common feature of:
- unregulated proliferation of leukocytes in the bone marrow and suppression of other cells, including RBC’s and platelets.
- acute leukemia
What are these clinical manifestations of:
- fever, infection from neutropenia
- weakness, fatigue from anemia
- bleeding tendencies from thrombocytopenia
- enlarged spleen
- hyperplasia of the gums
- bone pain from expansion of the bone marrow.
- Acute Myeloid Leukemia
How do you diagnosis acute myeloid leukemia?
- bone marrow aspiration
- biopsy
Complications of AML?
- bleeding and infection are the most common causes of death
What is the most optimal treatment for AML?
- a stem cell transplant other wise you focus on optimal quality of life.
When a patient with AML is a candidate for a stem cell transplant what are the next steps?
- induction therapy chemo/radiation > to destroy abnormal cells
- then consolidation chemo/radiation > to destroy residual abnormal cells
- then the stem cell transplant
Nursing management for AML is aimed at?
- assessing, monitoring and providing care towards infection prevention, bleeding prevention, and promoting comfort, and patient education.
What am I:
- uncontrolled proliferation of immature lymphoid cells, B- cells, and T-cells.
- peak incidence 4 years of age, higher in boys, survival rate increases with age.
- Actue lymphocytic leukemia (ALL)
What are these clinical manifestations of?
- immature lymphocytes proliferate and impede the development of normal myeloid cells, results in reduced number of leukocytes, erythrocytes, and platelets.
- leukemic cells infiltrate into other organs causing pain to enlarged spleen or liver and bone pain
- the testes and the CNS are sanctuary sites for leukemic cells: may cause swelling in testes or discomfort, HA, visual changes, vomiting, and neurologic deficits
- children may report bone and joint pain
- acute lymphocytic leukemia (ALL)
How do you diagnosis ALL?
- bone marrow aspiration and biopsy
- lumbar puncture
What is the treatment for ALL?
- may involve chemo into the intrathecal space at the time of lumbar puncture.
Mean should have a testicular exam because the testes are a sanctuary for?
- acute lymphocytic leukemia (ALL)
For nausea and pain in patients with AML and ALL is often from?
- mucositis: this is pain and inflammation of the mucous membranes lining the digestive tract
What lab values should you monitor for AML and ALL?
- leukocyte count
- ANC
- hematocrit
- platelets
- creatinine
- electrolytes
- liver function tests
What are the phases of chronic myeloid leukemia (CML)?
- chronic
- accelerated
- acute
Which phase of CML is when most of the leukocytes produced are mature and retain some ability to function normally?
- chronic
What phase of CML is when the number of abnormal cells are being produced at a faster rate?
- accelerated
What phase of CML is when the predominant cell type is immature?
- acute
Which phase are most patients with CML diagnosed in?
- chronic
Untreated CML will progress to the advanced phases in ______ years.
3 - 5
Research has shown that CML is primarily due to?
- chromosomal abnormality
Myeloid cells that over proliferate in the liver and spleen cause?
- pain and enlargement
What are these symptoms of:
- fatigue, night sweats abdominal pain, early satiety (feeling of fullness), and weight loss
- extremely high leukocyte counts (over 100,000) may have signs of leukostatis - high volume of leukocytes slows blood flow through the capillaries due to increased viscosity
- signs may be confusion, vision changes, SOB, chest pain due to decreased capillary perfusion to the brain, eyes, and lungs
- may have enlarged tender spleen, liver may be enlarged
- CML
Medication for CML:
- tyrosine - kinase inhibitor
* * avoid grapefruit juice, antacids, PPI’s **
What do you monitor during CML therapy?
- CBC with expected normalization within the first 4 - 6 weeks.
- continued monitoring about every 3 months.
- WBC need to be quickly reduced to minimize complications.
What leukemia is this:
- excessive accumulation of cells in the marrow and circulation, primarily B lymphocytes
- elevated lymphocyte count, can exceed 100,000/mm
- lymphadenopathy
- hepatomegaly and splenomegaly develop
Chronic lymphatic Leukemia (CLL)
