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Leukemia Flashcards

(41 cards)

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1
Q

what is leukemia

A

malignant neoplasm of blood forming organs

*high incidence in kids

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2
Q

leukemia is characterized by

A

an abnormal overproduction of immature forms of any of the leukocytes

  • interference with normal blood production
  • leads to decreased RBC and platelets
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3
Q

four problems r/t leukemia

A

1) anemia results d/t decreased RBC and blood loss
2) immunosuppression d/t increased # immature WBC (profound neutropenia)
3) hemorrhage d/t thrombocytopenia (low platelet ct)
4) invasion of other organs (liver, spleen, lymph, kidneys, lungs, and brain)

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4
Q

normal RBC

A

4-5/6 million mcL

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5
Q

normal WBC

A

4500-11000

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6
Q

normal platelets

A

150,000-450,000

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7
Q

diagnosis of leukemia

A
  • biopsy
  • bone marrow aspiration
  • lumbar puncture
  • frequent blood cts
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8
Q

general treatment of leukemia

A

antineoplastic chemo

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9
Q

causes of leukemia

A
  • genetics
  • ionizing radiation
  • viral infections (human T cells)
  • chemicals/drugs
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10
Q

-inability of leukocytes to mature (those that do are abnormal)
-occurs at any time during life cycle
onset is insidious

A

Acute Myelogenous Leukemia (AML)

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11
Q

prognosis for AML

A
  • POOR prognosis
  • 5 yr survival is 20%
  • 50%n survival for kids
  • cause of death tends to be d/t overwhelming infection
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12
Q
  • abnormal production of granulocytic cells
  • biphasic disease
  • young to middle aged adults
A

Chronic Myelogenous Leukemia (CML)

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13
Q

prognosis for CML

A
  • Poor prognosis
  • 5 yr survival is 37%
    cause: ionizing radiation , chemicals
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14
Q

CML stages

A

chronic stage is about 3 yrs

acute phase is about 2-3 mos

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15
Q
  • abnormal leukocytes found in blood forming tissue

* most common in children (most common kid cancer)

A

acute lymphocytic leukemia (ALL)

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16
Q

prognosis for ALL

A

GOOD

>5 yr prognosis is 80%

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17
Q
  • increased production of leukocytes and lymphocytes and proliferation of cells within bone marrow, spleen, liver
  • occurs after age 35 (older adults)
Study These Flashcards
A

chronic lymphocytic leukemia (CLL)

18
Q

prognosis for CLL

Study These Flashcards
A

GOOD

5 yr survival is 75%

19
Q

important to remember about CLL

Study These Flashcards
A

often asymptomatic and NOT treated

20
Q

treatment of CML

Study These Flashcards
A
  • conservative, oral antineoplastic agents
  • (Hydrea) Hydroxyurea- DNA synthesis inhibitor
  • Interferon (unknown)
  • (Gleevec) Imatinib mesylate- if cells are philadelphia chromosome positive
21
Q

leukemia nursing assessment

Study These Flashcards
A
  • tendency to bleed ( petechia, nosebleeds, bleeding gums, ecchymoses, nonhealing skin abrasions)
  • anemia (fatigue, pallor, headache, bone/joint pain, hepatosplenomegaly)
  • infection: fever, tachycardia, lymphadinopathy (swollen lymph nodes), night sweats, skin infections)
  • GI distress: anorexia, abd pain, wt loss, sore throat, diarrhea
22
Q

in an immunosupressed person, infection manifests as _____

Study These Flashcards
A

increased temp

  • lower parametes (ie/ report if > 38.05 or 100.49)
  • do thorough assessment frequently
23
Q

what is a salicylate

24
Q

most oncologic drugs cause _______

Study These Flashcards
A
  • immunosupression
  • prevent secondary infections
  • stay away from people with colds
  • private room
  • sterile/clean environment
  • no RAW veggies/fruits, ensure cooked
25
interventions if immunosuppressed
- monitor WBC daily - assess oral cavity and genitals for yeast - monitor VS frequently - administer abx - teach/enforce infection control - oral hygiene regimen - encourage coughing and deep breathing - AVOID rectal temp - monitor fluids (encourgae 3L/day) - encourage mobility - assess for bleeding, NO salicylates
26
what should the oral hygeine regimen entail
- soft toothbrush - no salt and soda - water soluble lubricant for lips - NO lemonglycerin swabs
27
what to remember about abx
-notify HCP if delay in admin trough (before admin) peak (30 min to 1 hr after admin)
28
this is toxic to cancer AND normal cells of both client and caregiver infusing
antineoplastic chemo
29
who may be prohibited from administering chemo
if pregnant or wanting to become pregnant
30
precautions with antineoplastic chemo drugs
- wear gloves when handling drugs | - check drug with another nurse to ensure prescription correck
31
if IV cath line used for infusion...
verify line placement and patency with another nurse and aspirate for blood return
32
if vesicant drug is administered peripherally...
- stay with pt and check IV placement and patency frequently, aspirate for blood return - use new side DAILY (dispose in specifically provided waste receptacle)
33
extrapyramidal s/s
(d/t antipsychotic meds) - acute dyskinesia - parkinsonism - akinesia - akathisia - tardive dyskinesia - dystonic reactions - neuroleptic malignant syndrome
34
describe ondasetron HCl
*zofran -prevent or relieve N/V SE: headache (give analgesic)
35
how is ondasetron administered
30 min before chemo 1-2 hr before radiation *dilute IV injection in 50 mL NaCl
36
describe granisetron
-relieve N/V | SE: HTN, CNS stimulation, increased LE
37
assess for what if on granisetron
- extrapyramidal S/S - monitor liver enzymes - give only on day of chemo/radiation, 1 hr before
38
describe prochlorperazine and promethazine HCl
-N/V | SE: drowsiness, dizziness, EP, blurry vision, dry mouth, orthostatic hypotesion
39
how to administer prochlorperazine and promethazine HCl
- dilute if oral solution with juice * determine Baseline BP before - give deep IM - monitor BP
40
describe metoclopramide HCl, Haloperidol, Diaphenhydramine
- N/V | - SE: drowsiness, restlessness, fatigue, EP
41
what to assess for metoclopramide HCl, Haloperidol, Diaphenhydramine
- caution of decreased alertness * avoid alcohol - discontinue if EP s/s occur

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