Unit 15 Flashcards
What are the types of leukemia?
Acute myelogenous leukemia (AML - accounts for most of leukemias that are not ALL in kids)
Acute promyelocytic leukemia
Acute lymphocytic leukemia (ALL - 3/4 children have ALL)
Chronic myelogenous leukemia (rare in children, occurs most after 50 yrs of age, 3 phases (chronic, accelerated, blast))
Chronic lymphocytic leukemia (CLL)
What is nursing care for leukemia?
Prevent infection - wear a mask if needed
Drug therapy
HSCT
Minimize injury
Conserve energy
What is the patho of leukemia?
Loss of normal CELLULAR REGULATION leading to immature WBCs in the bone marrow
Treatment is long!
What is the importance of collaborative care with leukemia?
To prevent infection (decreased immunity)
To prevent injury (poor CLOTTING)
To stabilize energy demands (decreased GAS EXCHANGE)
What are the 3 phases of leukemia?
induction - rapid complete remission;
consolidation - hit it hard while in remission (can be the same or a different combination of medication);
maintenance
What are common complications of cancer and Tx?
CAUTION - change in bowel/bladder, a sore that doesn’t heal, unusual bleeding/discharge, thickening or lump, Indigestions, obvious changes in wart, nagging cough or hoarseness
TX: targeted therapies, immunotherapies (different types), stem cell replacement
What is the teaching to reduce risk of infection and bleeding?
Take medications
Have good nutrition
Avoid crowds
Good hygiene
Monitor for fever
Stay away form raw fruits and veggies and plants (gardening)
How does HSCT work?
Collect stem cells from donor patient and give to sick patient; it is easier to collect from the bloodstream
Must destroy the blood before giving stem cells.
Graft-vs-Host disease
- acute: rash on hands/feet, jaundice, weight loss
- chronic: rash on hands/feet, blister and peel, itchy and dry
What is Hodgkin’s lymphoma? Non-Hodgkins lymphoma?
Hodgkins has the reed-sternberg cell; this cancer is in the lymph nodes, usually predictable spread
Non-Hodgkins is spread through the lymphatic system in a less orderly fashion
What are complications of hodgkins? Tx? How about non-hodgkins?
Hodgkins complications: cardiovascular disease, 2nd malignancies from radiation, restrictive lung disease, infertility
Non-Hodgkins complications: Cytokine release syndrome (caused from biological engineered T-cells that target cancer) - high fever, low BP, fluid retention, and confusion (usually resolves within 1-2 weeks)
Tx: monitor for pancytopenia (place on fall and bleed risk), manage chemo/radiations/s, educate about fertility preservation, monitor for complications
What is the patho for brain tumors?
Primary: originate in the brain: meningiomas (most common site), gliomas (deadly, <5yr survival), nerve sheath tumor, pituitary tumor, lymphomas, oligodendrogliomas, medulloblastomas
Secondary: metastatic tumors originating elsewhere and migrating to brain
What are the interventions for brain tumors?
Radiation
Chemo
Surgical - biopsy
What is the post-TX teaching for brain tumors?
Watch for signs of complications:
- increased ICP
- hematoma
- respiratory
- hypovolemic shock
- wound infection
- seizures
- CSF leak (halo sign)
- Dehydration
What are the classification of brain tumors?
Benign, malignant, or metastatic
Secondary is based on location (infratentorial, meningiomas, acoustic neuromas, and supratentorial)
What are assessment findings of brain tumors?
Headaches
N/V
Seizures
Impaired SENSORY PERCEPTION - tingling
Loss of balance
Weakness
Difficulty thinking
Changes in COGNITION
What is the patho of lung cancer?
What are the interventions for lung cancer?
Palliation (to relieve or lessen without curing): O2 therapy, drugs, radiation, dyspnea management, pain management, hospice
Surgical management
Nonsurgical
What are the assessment findings for lung cancer?
History
Pulmonary/nonpulmonary manifestations
Psychosocial
Diagnostic
What are the non surgical and surgical interventions for lung cancer?
Surgical: lobectomy or pneumonectomy (full lung) — always place a chest tube
Nonsurgical: chemo, radiation, targeted, photodynamic (remove small cell bronchial tumors via bronchoscope - there is a drug that lights up rapid multiplying cells and then the photodynamic targets the cell and causes death - watch for sluffing)
What are common cancer treatments?
Radiation - don’t be by children or pregnant women, be aware of bodily fluids
Chemo - don’t set up chemo if pregnant, pharmacogenetics decide the type of chemo
Surgical - prophylactic (preventative measure), reconstructive, biopsy
What are common side effects of cancer therapy?
Myelosuppriesion
Impaired skin integrity
N/V/nutritional
Alopecia (hair loss)
Body image and self-esteem issues
Grieving
Fatigue
Chronic pain
What medication are you going to give in sepsis with cancer?
Demerol - for shaking chills
Tylenol for temp
Antifungals, virals, and pyretics
Antibiotics
