WBC Disorders and Malignant Lymphomas Flashcards
What is Leukemia?
A type of cancer with uncontrolled production of immature white blood cells (WBCs).
What do immature WBCs do?
They cannot provide protection from infection.
What is the function of WBCs?
They provide protection from infection.
What is the pathophysiology of uncontrolled WBC production?
Uncontrolled production of immature WBCs in the bone marrow
What happens to the bone marrow in this condition?
Bone marrow becomes overcrowded with nonfunctional cells
What is the effect on normal blood cell production?
Production of normal blood cells is greatly reduced
What is the onset of Acute Leukemia?
Sudden onset
What is the duration of Acute Leukemia?
Short duration
How quickly do changes occur in Acute Leukemia?
Changes occur rapidly
What is the most common type of leukemia in children/teens and young adults up to 39?
Acute Leukemia
What is the onset of Chronic Leukemia?
Slow onset
How long may symptoms of Chronic Leukemia persist?
Symptoms may persist for years
How long can Chronic Leukemia be present before symptoms appear?
Present for years before symptoms appear
What is the median age of diagnosis for Chronic Leukemia?
Median age of diagnosis is 69.
What are the two types of leukemia based on cell type?
Lymphocytic
Myelocytic
What are the subtypes of Lymphocytic leukemia?
Acute Lymphocytic Leukemia (ALL)
Chronic Lymphocytic Leukemia (CLL)
What are the subtypes of Myelocytic leukemia?
Acute Myelogenous Leukemia (AML)
Chronic Myelogenous Leukemia (CML)
Which leukemias have acute sudden onsets?
Acute Lymphocytic Leukemia (ALL)
Acute Myelogenous Leukemia (AML)
How long can symptoms of CLL and CML be present?
Symptoms can be present for years.
What was the overall five-year relative survival rate from 2012 to 2018?
70.8 percent
What was the five-year relative survival rate for children and adolescents under 15 years?
92.1 percent
What was the five-year relative survival rate for children under 5 years?
93.3 percent
What was the five-year relative survival rate for AML?
30.5 percent
What was the five-year relative survival rate for children and adolescents with AML?
69.0 percent
What was the five-year relative survival rate for CLL?
87.9 percent
What was the five-year relative survival rate for CML?
70.4 percent
What are the risk factors for leukemia?
Exposure to ionizing radiation
Medications
Previous illnesses
How does age affect leukemia risk?
Risk for adult-onset leukemia increases with age.
What should be assessed regarding infections in leukemia patients?
Frequency and severity of infections in the past 6 months.
What symptoms indicate excessive bleeding in leukemia?
Nosebleeds
Hematuria
What are common symptoms of leukemia?
Fatigue
Headaches
Behavior changes
Increased somnolence
Decreased alertness
Muscle weakness
Loss of appetite
Weight loss
What will laboratory findings likely show for hemoglobin (Hgb)?
Decreased levels
What will laboratory findings likely show for hematocrit (Hct)?
Decreased levels
What is a common finding for platelet count?
Low platelet count
What will laboratory findings show for fibrinogen and other clotting factors?
Reduced levels
What is the abnormal range for WBC count?
20,000 to 100,000
What is the definitive test for leukemia?
Examination of cells from bone marrow aspiration
What does a bone marrow biopsy show in leukemia?
Bone marrow is full of immature cells
What may cytogenetic studies identify in leukemia?
Marker chromosomes in abnormal cells
What is the most common form of leukemia?
Acute Myeloid Leukemia (AML)
What is the focus of AML treatment?
Symptom management and chemotherapy
What is used in drug therapy for AML?
Chemotherapeutic agents
What is a major cause of death in clients with leukemia?
Infection
What is a common complication in leukemia patients?
Sepsis
What is bone marrow transplantation?
A procedure where a patient receives healthy stem cells to replace damaged ones.
Where are blood stem cells produced?
In the bone marrow.
What can stem cells become?
Any kind of blood cell the body needs.
What happens after stem cells are infused?
They travel to the bone marrow and form new healthy blood cells.
What is the most common type of adult leukemia?
Acute Myeloid Leukemia (AML)
What is a priority nursing diagnosis for AML?
Risk for infection related to decreased immune response
What is another priority nursing diagnosis for AML?
Risk for bleeding
What is an intervention for risk for infection?
Monitor vital signs
Maintain aseptic technique
Educate on hand hygiene
What is an intervention for risk for bleeding?
Monitor platelet counts
Avoid invasive procedures
Educate on safety measures
What should be maintained for a client with Leukemia?
Asepsis
What should clients and families be taught about infections?
Signs and symptoms of infection to report to HCP
What should be encouraged for clients with Leukemia?
Fluid intake as appropriate
What are malignant lymphomas?
Cancers of the lymphoid tissues with abnormal overgrowth of lymphocytes.
What are the two types of malignant lymphomas?
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma
What is a characteristic symptom of Hodgkin’s lymphoma?
Large, painless lymph node or nodes
What type of cell is a marker for Hodgkin’s lymphoma?
Reed-Sternberg cell
At what ages does Hodgkin’s lymphoma typically peak?
Teens and young adults
Adults in their 50s and 60s
What is the etiology of Hodgkin’s lymphoma?
Unknown; possible viral infections, but many cases have no known risk factors
Which gender has a higher incidence of Hodgkin’s lymphoma?
Males
How treatable is Hodgkin’s lymphoma?
One of the most treatable forms of cancer
What is the 5-year survival rate for early-stage Hodgkin’s lymphoma?
90%
When is Hodgkin’s lymphoma usually diagnosed?
Before reaching advanced stage
What cells are revealed in a biopsy for diagnosis?
Reed-Sternberg cells
What is a common assessment finding in lymphoma?
Large lymph node(s)
What type of fever may occur in lymphoma patients?
Low grade fever over time
What are common symptoms of lymphoma?
Night sweats
Unintentional weight loss
Severe itching
What symptom can occur after ETOH consumption in lymphoma?
ETOH induced pain at the lymph node site
What is a CT scan used for?
Imaging internal structures
Diagnosing diseases
Guiding treatment
What does a PET scan measure?
Metabolic activity
Blood flow
Oxygen usage
What is an MRI primarily used for?
Detailed imaging of soft tissues
Brain and spinal cord evaluation
Joint assessment
What is the treatment for Stage I and II?
External radiation of involved lymph node
What is the treatment for more extensive progression of disease?
Chemotherapy
Radiation
What are patients with drug induced pancytopenia at risk for?
Infection
Bleeding
Anemia
What are common side effects of therapy for Hodgkin Lymphoma?
Severe nausea/vomiting
Skin problems at the site
Constipation or diarrhea
What is a risk for male patients receiving radiation to the lower abdomen?
Permanent sterility
What is non-Hodgkin’s lymphoma?
Includes all lymphoid cancers that do not have the Reed-Sternberg cell.
Who is more commonly affected by non-Hodgkin’s lymphoma?
More common in men and older adults.
How does non-Hodgkin’s lymphoma spread?
Spreads through the lymphatic system in a less orderly fashion than Hodgkin’s lymphoma.
How many subtypes of non-Hodgkin’s lymphoma are there?
Over 60 subtypes, divided into indolent or aggressive NHL.
What are the two broad classifications of non-Hodgkin’s lymphoma?
B-cell or T-cell lymphoma, depending on the lymphocyte type
Whch type of lymphoma is most common in non-Hodgkin’s lymphoma?
B-cell lymphomas are most common.
What does the prognosis of non-Hodgkin’s lymphoma depend on?
Depends on stage, type, and location.
What is the 5-year survival rate for non-Hodgkin’s lymphoma?
70% 5-year survival rate.
What is Stage I lymphoma?
Cancer is limited to a single node.
What is Stage II lymphoma?
Cancer is found in two or more lymph nodes on the same side of the diaphragm.
What is Stage III lymphoma?
Cancer is found in lymph groups on both sides of the diaphragm.
What is Stage IV lymphoma?
Cancer is found in one or more organs in addition to lymph nodes
What factors influence treatment options for tumors?
Subtype of tumor
Stage of disease
Patient’s overall health
Patient preferences
What is a possible approach for slow-growing lymphoma?
A wait-and-see approach may be an option.
When may indolent lymphomas not require treatment?
If they don’t cause signs and symptoms, treatment may not be needed for years.
What are common treatment options for lymphoma?
Radiation therapy
Chemotherapy
Biologics (e.g., Rituximab)
Bone marrow transplant
Clinical trials
