T11: Leukemia

Question 1

leukemia

Answer 1

“blood cancer” a group of malignant disorders affecting the blood and blood-forming tissues of bone marrow, lymph system, spleen; accumulation of dysfunctional cells due to loss of regulation in cell division; WHITE BLOOD CELL PROBLEM (immature and non-functioning)

Question 2

normal WBC

Answer 2

5,000-10,000

Question 3

leukemia has ischemia (aches and pain) because…

Answer 3

there are too many WBCs in circulation

Question 4

acute

Answer 4

clonal proliferation of IMMATURE HEMATOPOIETIC CELLS

Question 5

chronic

Answer 5

mature forms of WBC and onset is more gradual

Question 6

Acute lymphocytic leukemia (ALL)- Based on type of WBC

Answer 6

Lymphocytes-viral

Question 7

Acute myelogenous leukemia (AML) Based on type of WBC

Answer 7

Neutrophils-bacterial

Question 8

Acute Myelogenous Leukemia (AML)

Answer 8

Abrupt, dramatic onset with serious infection or abnormal bleeding
o BRUISING, gums bleed while brushing teeth, blood in urine
Uncontrolled proliferation of myeloblasts; hyperplasia of bone marrow and spleen

Question 9

most common type of leukemia in children

Answer 9

Acute lymphocytic leukemia (ALL)

Question 10

clinical manifestations of acute lymphocytic leukemia

Answer 10

o Abruptly: Fever, Bleeding. bruising
§ Fever of unknown origin
o Insidiously: Progressive weakness, fatigue, pain, bleeding tendencies
- Kid is super tired and lethargic
o CNS: Leukemic Meninigitisarachnoid infiltration

Question 11

Chronic Myelogenous Leukemia (CML)

Answer 11

excessive mature neoplastic granulocytes in bone marrow; move into peripheral blood in massive numbers, ultimately infiltrating liver and spleen

Question 12

diagnostic for Chronic Myelogenous Leukemia (CML)

Answer 12

HINT HINT: Philadelphia chromosome

Question 13

most common leukemia in adults

Answer 13

chronic lymphocytic leukemia (CLL)

Question 14

leukemia clinical manifestations: ANT

Answer 14

Anemia, Neutropenia, Thrombocytopenia

Question 15

Leukemic white cell count in the peripheral blood

Answer 15

> 100,000/µL

Question 16

Leukemic white cell count in the peripheral blood is >100,000/µL and causes

Answer 16

o a high leukemic WBC count in peripheral blood
o Blood thickens and blocks circulatory pathways
- PAIN BECAUSE OF CLOTS, MAKE SURE THEY AREN’T INFARCTING OTHER ORGANS

Question 17

complete remission

Answer 17

: no evidence of overt disease is found on physical examination, and the bone marrow and peripheral blood appear normal.

Question 18

partial remission

Answer 18

is characterized by lack of symptoms and a normal peripheral blood smear, but evidence of disease is still seen in the bone marrow.

Question 19

Minimal residual disease

Answer 19

is defined as tumor cells that cannot be detected by morphologic examination but can be identified by molecular testing.

Question 20

molecular remission

Answer 20

indicates that all molecular studies are negative for residual leukemia.

Question 21

Stages of chemotherapy

Answer 21

o 1. Induction-nursing interventions focus on neutropenia, thrombocytopenia, and anemia
o 2. Postinduction or postremission (consolidation)-intensification-HIGH DOSE-after remission
o 3. Maintenance-every 3-4 weeks, keep free of leukemic cells

Question 22

SE OF CHEMOTHERAPY

Answer 22

o Neutropenia: Neutropenic precautions
o Nausea:
- Medications, do not take in strong-smelling food cauliflower, broccoli, onions, etc
- IV fluids and watch electrolytes

Question 23

nadar

Answer 23

10-14 days after administration of chemo their WBC are NON-EXISTENT
o Check WBC on day 10, they are profoundly neutropenic

Question 24

for bone marrow transplant you need a…

Answer 24

HLA MATCH AND GET BONE MARROW FROM PELVIC GIRDLE

Question 25

HEMATOPOIETIC STEM CELL TRANSPLANT

Answer 25

Þ THIS IS A CURE IF THEY GET ALL THE BAD CELLS

Question 26

Erythropoietin (Epogen)

Answer 26

boosts health RBC in the patient FOR ANEMIA OF CHRONIC CANCER

Question 27

SE of Erythropoietin (Epogen)

Answer 27

hypertension, thrombosis, headache

Question 28

Granulocyte colony-stimulating factor (G-CSF): Filgrastim (Neupogen)

Answer 28

boost healthy WBC in patient FOR CHEMOTHERAPY-INDUCED NEUTROPENIA

Question 29

SE of Granulocyte colony-stimulating factor (G-CSF): Filgrastim (Neupogen)

Answer 29

o bone pain, N/V

Question 30

Interleukin-11 (platelet growth factor):

Answer 30

FOR THROMBOCYTOPENIA RELATED TO CHEMOTHERAPY

Question 31

SE of Interleukin-11 (platelet growth factor):

Answer 31

fluid retention, peripheral edema, dyspnea, tachycardia, nausea, mouth sores