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2.0 Adult Nursing Exam 4 > Hematologic part 3 > Flashcards

Hematologic part 3 Flashcards

1
Q

What does Lymphoma mean?

Where does it travel to?

A

Neoplasm or cancer from lymph nodes

Travels into lymph tissue such as spleen, GI, liver, and bone marrow.

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2
Q

Two categories of lymphoma:

A

Hodgkin

Non-Hodgkin

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3
Q

What is Hodgkins Lymphoma?

A

Cancer of the lymph nodes due to Reed Sternberg cells

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4
Q

How common is Hodgkins Lymphoma and who will we see it in?

A

Hodgkins is rare.

Will see it in those on immunosuppressants and veterans or farmers that were exposed to Agent orange.

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5
Q

How does Hodgkins Lymphoma spread?

How does dx go?

A

Originates in a single node and then spreads along the lymphatic system.

It can take multiple biopsies to find those Reed sternberg cells so they’ll do a lot

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6
Q

What age will you start to see Hodgkins Lymphoma?

A

Earlys 20’s. After 50

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7
Q

What assessment do you want to be doing to catch Hodgkins?

A

Check the clavicular chains of the cervical, supra-clavicular, & mediastinal for enlarged lymph nodes that are painless and usually on one side of neck.

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8
Q

What is the viral component associated with Hodgkins lymphoma?

A

Hodgkins patients test positive for Epstein - Barr

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9
Q

What type of symptoms will be present for a patient whose hodgkins has infiltrated other parts of the body?

A

Compression in nature.

- numbness and tingling for patients with a tumor on the spine for example

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10
Q

How common are B symtptoms in Hodgkins?

A

40% more common

- flu symptoms

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11
Q

What do they try to eliminate when diagnosing hodkins?

A

Infectious causes

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12
Q

Diagnosis of hodgkin details?

A

Lymph node biopsy of the reed-sternberg cells Xray, CT of abdomen, chest, and pelvis to see how far the cancer has gone.
Bone marrow inspection
CBC for mild anemia

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13
Q

Early stage of Hodgkin Lymphoma treatment

A

Short course of chemo of 2-4 months

Followed by radiation treatment to the specific areas

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14
Q

Treatment for advanced stage of Hodgkins

A

Combo chemo with ABVD

- Adrimycin, Blenoxane, Velban, DTIC

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15
Q

Where is possible secondary malignancy that can develop with Hodgkins?

A

Lung and breast cancer

Acute Myeloid Leukemia (AML)*****

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16
Q

What is Non-hodgkin Lymphoma?

A

New cells grow into lymph tissue from a single clone lymphocyte that is malignant

17
Q

What is the nature of infiltration or spread with Non-hodgkins?

A

Non-Hodgkins spread is unpredictable. Can go in lymph nodes and nonlymph tissue.

18
Q

What type of health history is common with Non-Hodgkins patients

A

Immunodeficiencies & autoimmune disorders
Previous cancer treatment
Organ transplant
Viral infections
Agent Orange exposure or chemicals like pesticides

Really a patient who is already sick.

19
Q

Most common symptoms of Non-hodgkins?

A

Lymphadenopathy - enlarged lymph nodes

20
Q

When is Non-hodgkins typically diagnosed?

A

Later stages bc only 1/3 of people have any flu-like symptoms or B symptoms. They walk around with it and have no clue

21
Q

What is the usual occurrence that takes people in for Non-Hodgkins?

A

CNS compression symptoms

22
Q

Diagnostic tests used for Non-hodgkins

A

CT
PET - shows metabolic activity of tumors
Bone marrow biopsy
CSF analysis if there’s CNS involvement

23
Q

Localized Non-Hodgkins treatment?

A

Radiation

24
Q

What is the aggressive combination chemo for Non-Hodgkins?

A

Monoclonal antibody

25
Q

Treatment for Non-Hodgkins patients with CNS involvement

A

Intrathecal chemo or cranial radiation

26
Q

Why are patients with cancers at risk for DIC?

A

The affect the cancer has on the blood cells and platelets

27
Q

What will platelets be like if a patient is at risk for DIC

A

Decreased platelet count

28
Q

If a patient has DIC, what happens to PT?

A

Increased PT

29
Q

If a patient has DIC, what happens to PTT?

A

Increased PTT

30
Q

What will the D-dimer lab be like if the patient has DIC?

A

Increased

31
Q

DIC labs to know

A

Decreased platelets
Increased PT
Increased PTT
Increased D-dimer

32
Q

DIC symptoms

A

Petechia
Bleeding of gums or nose - check membranes
Foley bleeding
Prolonged bleedings
Ecchymosis
Hemorrhage into subcutaneous tissues that is purple
Oozing from multiple sites

(think, what would you assess for patients on blood thinners)

33
Q

When working up for DIC, what other disease is similar?

A

Menningitis

34
Q

What is the worry with DIC?

A

Mortality from ischemic thrombosis and bleeding out from hemorrhage

35
Q

How do we treat and manage DIC?

A

Treat what caused the DIC
Oxygen
Fluids
Electrolyte management

36
Q

How can Cryoprecipitate help DIC?

What factors?

A

It replaced fibrinogen and helps clotting factors V and VII.
- if these factors are in deficit, they have increased risk of bleeding out

37
Q

What does FFP or fresh frozen plasma do for DIC?

A

The FFP can replace other factors and volume

2.0 Adult Nursing Exam 4 (8 decks)

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