Leukemia

Question 1

What is Leukemia?

Answer 1

• A cancer that affects the blood cells & bone marrow
• There is an overproduction of WBCs that crowd out the production of other cells
• As bone marrow produces WBCs, RBCs, and platelets, this leads to low RBCs and low platelets and all the applicable s/s.

Question 2

What are the two types of cells affected by leukemia?

Answer 2

• Lymphocyte: for lymphatic system function
• Myeloid: precursor cells the develop into WBCs (other than lymphocytes), RBCs, Platelets

Question 3

What are the 4 main types of Leukemia?

Answer 3

• Acute myeloid leukemia (AML) – found more in children
• Chronic myeloid leukemia (CML)
• Acute lymphocytic leukemia (ALL)
• Chronic lymphocytic leukemia (CLL)

Question 4

What are the typical lab results that indicate possible leukemia?

Answer 4

• High WBCs
• Low H/H
• Low Platelets
• Low RBCs

Question 5

What are the common s/s of leukemia?

Answer 5

• Freq infections
• Fatigue, unsteady gait, pale “pallor”
• Bruising, petechiae, easy bleeding
• Weight loss & anorexia
• Bone pain

Question 6

True or False
A leukemia pt is not as susceptible to infections due to the increase WBC counts found in leukemia.

Answer 6

• False, they are more susceptible

Question 7

What is the common tx for leukemia?

Answer 7

• To kill the cancer:
  
  • Radiation
  • Chemotherapy
• • To reboot bone marrow
  
  • Stem cell transplant

Question 8

Why is the leukemia patient more susceptible to infection despite having an increase of WBCs?

Answer 8

• Lymphocytes have become damaged and non-functional.
  
  • These damaged cells proliferate reducing the ability of the lymphatic system to do its job
• They can also crowd out other cell production preventing myeloid cell development into new WBCs, RBCs, Platelets, etc

Question 9

What are some key differences between acute and chronic leukemia?

Answer 9

• Acute:
  
  • Clonal proliferation of IMMATURE hematopoietic cells
  • Abrupt onset, often occurring within a few weeks
  • Shorter survival rate
• • Chronic
  
  • Mature forms of WBCs affected
  • Gradual onset
  • Longer survival rate

Question 10

What are some possible risk factors for developing leukemia?

Answer 10

• Previous cancer tx
• Genetics, Family hx of leukemia
• Smoking
• Exposure to certain chemicals (such as benzene)

Question 11

What kinds of s/s are common with leukemia?

Answer 11

• Any related to dysfunction in WBCs (infection s/s), RBCs (anemia/fatigue/O2), Platelets (bleeding, bruising)

Question 12

What is the path of diagnosis of leukemia?

Answer 12

• S/s (if present) or labs return indicating possible leukemia
• Physical exam
• Blood tests
• Bone marrow tests

Question 13

What are some key factors indicating a poor prognosis when dx’d w/ leukemia?

Answer 13

• Increasing age
• Male sex
• High leukocytes count at diagnosis
• CNS involvement at diagnosis
• Antecedent hematological disorder
• Cytogenetic abnormalities

Question 14

True or False

Chemotherapy reduces sperm count

Answer 14

True

Question 15

What are 3 key things to teach the leukemia patient and significant other

Answer 15

1. Diligence in disease management
2. Need for follow-up care
3. When to seek medical attention

Question 16

Maintaining a good intake and output is essential together with replacement of electrolytes especially of _____ and _____.

Answer 16

potassium and magnesium

Question 17

What are 5 nursing goals to meet for rehabilitation post chemotherapy for leukemia?

Answer 17

• Manage the consequences.
• Physical
• Psychosocial
• Social
• Spiritual