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chronic > hodgkin's/NHL > Flashcards

hodgkin's/NHL Flashcards

1
Q

what is lymphoma

A

An overgrowth of lymphocytes (cancer of the lymph system)

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2
Q

cause of lymphoma

A
  1. Viral Cause (Epstein-Barr virus implicated)- often seen in patients immunocompromised (HIV, organ transplants) or with autoimmune disorders
  2. Genetics? (increased among twins, Jews)
  3. Exposure to herbicides, chemicals
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3
Q

lymphoma differs from leukemias in

A

Degree of cell maturation
Location of cell production
Discrete tumor formation

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4
Q

types of lymphomas

A

Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma (NHL)
Burkitt’s lymphoma (seen in children, persons with AIDs)

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5
Q

primary lymphoma

A

overgrowth occurs in thymus and bone marrow

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6
Q

secondary lymphoma

A

overgrowth occurs in lymph nodes, spleen, tonsils, intestinal lymphoid tissue (more common)

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7
Q

hodgkin’s lymphoma patho

A

Characterized by a distinctive large cell, called a Reed and Sternberg cell
Enlargement of lymph glands, spleen & liver can occur

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8
Q

hodgkin’s incidence

A

Bimodal: peaks incidence occurs in mid 20s and after age 50
Males affected more than females

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9
Q

hodgkin’s clinical manifestations

A
  1. Painless Lymphadenopathy (Cervical, supraclavicular, mediastinal regions)
  2. Mediastinal Mass on CXR (50% of cases)
  3. Nonproductive cough
  4. unexplained weight loss
  5. night sweats
  6. Fatigue, weakness,
  7. Pruritus
  8. Alcohol induced bone pain
  9. Unexplained fever
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10
Q

other symptoms of hodgkin’s based on location and degree of lymph node obstruction with disease progression

A

 Jaundice
 Hepatomegaly
 Spleenomegaly
 Nerve Pain

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11
Q

hodgkin’s diagnostics

A
  1. Biopsy of Nodes
  2. CXR
  3. Bone Marrow Biopsies
  4. CT/MRI of Chest/Abdomen
  5. CBC
  6. Liver function tests
  7. Lymphangiography
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12
Q

hodgkin’s staging is critical for

A

Selecting appropriate treatment

Determining prognosis

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13
Q

If diagnostic tests cannot determine extent of disease (hodgkin’s)

A

a staging laparotomy may be performed

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14
Q

hodgkin’s stage 1

A

single node/organ/site

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15
Q

hodgkin’s stage 2

A

2 or more nodes, or one nodes and one organ/site on the same side of diaphragm

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16
Q

hodgkin’s stage 3

A

nodes on both sides of diaphragm (with or without spleen or organ/site involvement

17
Q

hodgkin’s stage 4

A

Disseminated involvement, widespread disease

18
Q

hodgkin’s stage 1&2 management

A

radiation and chemo

19
Q

hodgkin’s stage 3&4 management

A

Combination chemo and (targeted) radiation

20
Q

hodgkin’s prognosis

A

One of most curable cancers

10yr. survival rate of 76%

21
Q

teachable nursing considerations for hodgkin’s

A

Precautions related to pancytopenia

Precautions related to external radiation

22
Q

hodgkin’s concerns related to sexuality

A

infertility (esp because it occurs in mid 20s age group)

23
Q

non-hodgkin’s lymphoma

A

5-7X more common than Hodgkin’s lymphoma
Males affected more than females
More predominant in whites
Increased incidence after 50 to 60 years

24
Q

NHL patho

A

Abnormal growth of lymphocytes fixed at one phase of development

25
Q

NHL types

A 
The REAL (Revised European-American Lymphoma) classification recognizes 30 subtypes
For practical purposes, NHLs grouped as aggressive (high-grade) or indolent (low-grade)
26
Q

NHL clinical manifestations

A
  1. Similar to those for Hodgkin’s
  2. Asymptomatic; incidental mss identified on CXR
  3. Enlarged, “painless” lymph node “B” symptoms: (night sweats, fever, unexplained weight loss)
  4. fatigue
  5. Anemia
  6. Spleen or liver enlargement
  7. Obstructive sx of pressure on other tissues/structures (kidneys, nerves, trachea, etc)
27
Q

NHL diagnostics

A

Diagnostics similar to those for Hodgkin’s

Gallium Scan: Use of radioactive gallium IV to locate aggressive lymphoma

28
Q

NHL management

A

-Dependent upon grade (low or high) and stage (Staging for NHL is similar to that used for Hodgkin’s lymphoma)
-Standard treatments for early stage are localized radiation and chemo
-Autologous stem cell transplants (for those who do not respond or relapse) or BMT for persons with high-grade NHL

29
Q

NHL nursing diagnostics

A
  1. Risk for Infection
  2. Risk for Injury: bleeding
  3. Fatigue
  4. Risk for Sexual Dysfunction
  5. Imbalanced Nutrition
  6. Disturbed Body Image
  7. Risk for Ineffective Therapeutic Regimen Management

chronic (17 decks)

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