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MED SURG > TOPIC 6 - leukemia > Flashcards

TOPIC 6 - leukemia Flashcards

1
Q

leukemia affects …

A

blood and blood forming tissues of the bone marrow
lymph system
spleen

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2
Q

causes of leukemia

A

mutation in the DNA
genetic and environmental influence
abnormal genes
chemical agents
chemotherapeutic agents
viruses
radiation
immunologic
persons previously treated with radiation or chemotherapy

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3
Q

affect of leukemia on erythrocytes

A

anemia
= weakness + pallor

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4
Q

affect of leukemia on lymphocytes

A

immunosuppression
= infection + fever

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5
Q

affect of leukemia on platelets

A

bleeding, decreased clotting, thrombocytopenia
= petechiae, bruising, purpura

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6
Q

common affected sites

A

CNS, testicles, lymph nodes, liver, spleen, joints

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7
Q

classifications of leukemia

A

acute : clonal proliferation of immature hematopoietic cells
chronic : mature forms of WBC and onset is more gradual

lymphocytic or myelogenous

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8
Q

chronic myelogenous leukemia causes

A

caused by excessive development of mature neoplastic granulocytes in the bone marrow

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9
Q

chronic myelogenous leukemia outcomes

A

the excess neoplastic granulocytes move into the peripheral blood flow and infiltrate the liver and spleen

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10
Q

stages of CML

A

chronic stable: can last for several years and be well controlled with meds
acute, aggressive phase: must be treated more aggressively

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11
Q

diagnostic hallmark of CML

A

philadelphia chromosome

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12
Q

CML clinical manifestations

A

no symptoms early on

fatigue, fever, sternal tender, weight loss, joint pain, bone pain, massive splenomegaly, increase sweating

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13
Q

diagnostic findings of CML

A

low RBC, low Hgb, low Hct, high platelet early on/ low platelet later on, increased banded neut + myeloblasts + basophils, normal lymph, normal or low monocytes

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14
Q

chronic lymphocytic leukemia is characterized by …

A

production and accumulation of functionally inactive but long lived small, mature appearing lymphocytes. B cells are usually involved
lymphocytes infiltrate the bone marrow, spleen, and liver

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15
Q

complications of CLL

A

rare early on but develop as disease advances

pressure on nerves = pain, paralysis
mediastinal node enlargement leads to pulmonary symptoms

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16
Q

chronic lymphocytic leukemia manifestations

A

frequently no symptoms

chronic fatigue, anorexia, splenomegaly, lymphadenopathy, hepatomegaly, fever, night sweats, weight loss, frequent infections

17
Q

CLL diagnostic findings

A

mild anemia and thrombocytopenia
WBC > 100,000
increase in peripheral lymphocytes and lymph in bone marrow

18
Q

leukemic cells infiltrating organs =

A

splenomegaly, hepatomegaly, lymphadenopathy, bone pain, meningeal irritation, oral lesions

19
Q

CNS symptoms

A

vomiting, headache, lethargy, seizure, coma, blurred vision

20
Q

leukostasis

A

high leukemic WBC
causes blood to thicken and potentially block circulatory pathways
life threatening

21
Q

diagnostic studies to determine leukemia diagnosis

A

peripheral blood evaluation
bone marrow exam
lumbar puncture and CT scan to detect leukemic cells outside of blood and bone marrow

22
Q

bone marrow examination

A

involves removal of bone marrow through a locally anesthetized site to evaluate status of blood forming tissue

before: explain procedure, consent, time out is done, analgesic admin
after: apply pressure dressing, assess site

23
Q

after each relapse, the succeeding remission …

A

is more difficult to achieve and shorter in duration

24
Q

treatment

A

chemo is mainstay
other meds: corticosteroids
radiation therapy
leukostasis treatment: leukaperesis, hydroxyurea

25
Q

nursing diagnosis

A

fatigue or activity intolerance
ineffective protection related to abnormal blood profile
risk for infection
knowledge deficit
anxiety related to unpredictability of the course of disease

26
Q

nursing interventions

A

maximize patients physical functioning
teaching patients that acute side effects are usually temporary
encourage discussion of quality of life

27
Q

evaluation

A

cope effectively
experience no complications
feel comfortable and supported

MED SURG (30 decks)

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