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AH2 Exam 3 > White Blood Cells Disorders > Flashcards

White Blood Cells Disorders Flashcards

1
Q

Leukemia - Pathophysiology

A
  • Uncontrolled WBC production
    > Cx occurs in stem cells of bone marrow; overcrowded w/ nonfunctional cells
  • Overproduction of Blasts cells (immature WBC)
  • Exact cause unknown: many genetic & envir’t facotrs involved
    > 50% of pts have abnormal chromosomes
  • Normal cell production DCRD
    > Pancytopenia: CMs; neutropenia, anemia, thrombocytopenia infiltration tissue/organ
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2
Q

Leukemia - Classifications

A
  • Acute
    > sudden onset abnormal blood cells
  • Chronic
    > abnormal cells replicate slowly
  • Classified by Cell Type
    > Lymphoid cells: Lymphocytic
    > Myeloid cells: Myelogenous
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3
Q

Acute Leukemia Types

ages

A
  • Acute Lymphocytic Leukemia (ALL)
    > most common type in young children
  • Acute Myelogenous Leukemia (AML)
    > most common type in all adults
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4
Q

Chronic Leukemia Types

ages

A
  • Chronic Lymphocytic Leukemia (CLL)
    > most common chronic adult leukemia
  • Chronic Myelogenous Leukemia (CML)
    > asymptomatic for yrs before entering a fast growth phase
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5
Q

Leukemia - Risk Factors

A
  • Prior exposure chemotherpay or ionizing radiation
    > prevous cancer
  • Bone marrow hypoplasia
  • Genetic factors
    > downs
  • Immune deficiency
  • Virus
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6
Q

Leukemia - Diagnosis

A
  • CBC
    > abnormal WBC; high blast cells poorer prognosis
    > low Hgb & Hct and platelets
  • Bone Marrow Biopsy
    > definitive test
  • Chromosome analysis
  • Other X-rays, CAT scans, MRI
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7
Q

Leukemia - CMs

psychological
lymph nodes
spleen/liver

A
  • Psychological
    > fatigue
    > loss of appetite
  • Lymph Nodes
    > swelling
  • Spleen and/or Liver
    > enlargement
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8
Q

Leukemia - CMs

skin
systemic

A
  • Skin
    > night sweats
    > easy bruising & bleeding
    > purplish patches or spots
  • Systemic
    > weight loss
    > fever
    > frequent infections
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9
Q

Leukemia - CMs

lungs
muscular
bones/joints

A
  • Lungs
    > easy SOB
  • Muscular
    > weakness
  • Bones or Joints
    > pain or tenderness
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10
Q

Leukemia - Diagnosis: Bone Marrow Aspiration

A
  • Provides info abt blood cells & production
  • Nursing
    > teach pt what to expect
    > position: prone or side-lying
    > sedative provided
    > local anesthetic injected
  • Follow-Up Care
    > control bleeding
    > inspect site every 2hrs
    > pain control
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11
Q

Leukemia - Medical Treatment

A
  • Induction Therapy
    > intense chemotherpay started as soon as diagnosis confirmed
    > hospitalized 2-3wks in protective isolation
    > Side Effects: severe bone marrow suppression, alopecia, N/V, stomatitis, organ toxicity
  • Consolidation Therapy
    > after recovery
    > repeat drugs or bone marrow transplant
  • Maintenance Therapy
    > months to yrs to maintain remission
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12
Q

Lymphomas

A
  • Cancer of lymphocytes
  • 2 main types:
    > Hodgkin’s Lymphoma (HL): “curable”, teens & adults in 50-60s
    > Non-Hodgkin’s Lymphoma (NHL): “non-curable”, all other lymphomas (over 60 types), older adult men
    > many subtypes of both
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13
Q

Palpable Nodes

cervical

A
  • Cervical
    > posterior cervical
    > pre-auricular
    > upper cervical
    > median or lower cervical
    > supraclavicular
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14
Q

Palpable Nodes

axillary
eiptrochlear
inguinal
popliteal

A
  • Axillary
    > axillary
  • Epitrochlear
    > epitrochlear
  • Inguinal
    > inguinal
    > femoral
  • Popliteal
    > popliteal
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15
Q

Non-Palpable Nodes

mediastinal

A
  • Paratracheal
  • Mediastinal
  • Hilar
  • Retrocrural
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16
Q

Non-Palpable Nodes

para-aortic

A
  • Para-aortic
  • Common iliac
  • External iliac
17
Q

Non-Palpable Nodes

mesenteric

A
  • Celiac
  • Splenic hilar
  • Portal
  • Mesenteric
18
Q

Hodgkin’s Lymphoma - Signs/Symptoms

A
  • Starts in a single lymph node in neck, underarm, or chest
    > proceeds in orderly fashion; connect the dots
  • Fatigue, anorexia, SOB
  • “B” symptoms: sweats, fever, itching, weight loss
  • Pain in node areas after alcohol intake
19
Q

Hodgkin’s Lymphoma - Risk Factors

A
  • Viral infections
  • Chemical exposure
20
Q

Hodgkin’s Lymphoma - Treatment

A
  • External radiation & chemo
  • Curable
21
Q

Non-Hodgkin’s Lymphoma - Symptoms

A
  • Lymphadenopathy in multiple sites
  • Already spread to other organs at diagnosis
22
Q

Non-Hodgkin’s Lymphoma - Risk Factors

A
  • Autoimmune disease
  • Immunosuppressive disorders
  • Viruses
    > HIV, Epstein-Barr
  • Chemicals
23
Q

Non-Hodgkin’s Lymphoma - Treatment

A
  • Chemotherapy/monoclonal antibodies
  • Radiation
  • Chronic disease
    > not curable
24
Q

Multiple Myeloma - Pathophysiology

A
  • Overgrowth of plasma cells (PC)
    > due to overproduction of gamma globulin (gammopathy)
    > excess antibodies in blood clog blood vessels of kidney and other organs then cause infection
  • Produce excess cytokines
    > incr cancer growth rate & destroy bone
25
Q

Multiple Myeloma - Diagnostic Tests

A
  • Serum Electrophoresis Test
    > detects monoclonal immunoglobulin
  • Bone Marrow
    > greater than 10% infiltrated plasma cells
  • X-ray
    > osteolytic bone lesions
26
Q

Multiple Myeloma - Early CMs

A
  • Fatigue
  • Anemia
  • Easy bruising
  • Bone pain
  • Infections
27
Q

Multiple Myeloma - Late CMs

A
  • Bone factures
    > due to infection
  • Kidney dysfunction
  • HTN
  • Rare:
    > hypercalcemia, hyper viscosity syndrome
  • Leads to progressive bome destruction, bleeding, kidney failure, immunosuppression, and death
28
Q

Multiple Myeloma - Treatment

A
  • Chemotherapy agents
  • Bone marrow transplant
  • INCURABLE
29
Q

Multiple Myeloma - Nursing Care

A
  • Care of immunocompromised pt
  • Pain control
30
Q

Nursing Care for Leukemia, Lymphoma, & Multiple Myeloma

A
  • Infection Protection
    > prophylactic drugs: antiviral, antibiotic, antifungals
    > neutropenic precautions
    > monitor labs daily
    > monitor for early manis of infection
    > hygiene/skin care
  • Thrombocytopenia precautions
  • Energy conservation
  • Teach self care
    > no crowds, identify infection
  • Psychosocial support
31
Q

Neutropenic Precautions

A
  • Avoid crowds, children/ill ppl/wear mask
  • Hand hygiene/good personal hygiene/mouth care
  • Avoid constipation
  • Shave w/ electric shaver
  • Do not handle feces
  • No fresh flowers/plants/no gardening
  • No invasive procedures
  • No sexual relations
  • Discuss food safety
    > no fresh fruits, veggies, raw meat, eggs, some cheeses
  • Pt should have thermometer & know how to use it
  • Who to notify & when
    > temp greater than 100.5, chills, signs of illness or infection
  • Wkly lab
  • Admin growth factor as directed
32
Q

Thrombocytopenic Precautions

A
  • Risk for injury: Risk factors: abnormal clotting
  • Assess for S/S of bleeding
    > bruises, nose, gums, urine, stool, severe headaches
  • Avoid IM/SQ/IV or invasive procedures
  • No Aspirin/NSAID
  • Soft toothbrush: no flossing or dental procedures
  • No razor blades
  • Stool softeners & laxatives to prevent straining
  • Hold pressure for 5 min on venipuncture sites
  • Teach signs of bleeding
    > when to notify doc
  • Safe envir’t
    > avoid situations where falls may occue

AH2 Exam 3 (12 decks)

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