Unit 23 Altered Cell Proliferation Leukemia, Lymphoma, Hospice Flashcards Preview

Nursing 4 Exam 4 > Unit 23 Altered Cell Proliferation Leukemia, Lymphoma, Hospice > Flashcards

Flashcards in Unit 23 Altered Cell Proliferation Leukemia, Lymphoma, Hospice Deck (23):
1

How is Leukemia classified?
What are the two types?

Classified by the cell line:
-Myeloid and Lymphoid

Lymphoid makes T, B, K cells

Myeloid makes everything else (platelets, RBCs, WBC's etc)

2

What is Polycythemia?
What are the symptoms?
What is the tx?
What are PT's at risk for?

Increased RBCs

-Hct > 55%
-Ruddy complexion
-Headache
-Vision problems
-Weight loss
-Enlarged spleen***

Tx:
-Phlebotomy (blood letting, donating blood)
-ASA (to prevent clots)
-hydroxurea (a metabolite Rx)
-Avoid iron

PT's at risk for Stroke, DVT

3

What is Myelodysplastic Syndrome?
What can it progress to?
What are the symptoms?
What are the risk factors?
What is the treatment?

Immature blood cells that don't mature (they die young)
Typical onset is 70 years old

-Can progress to Myeloid Leukemia

Symptoms:
-Decreased RBCs, WBCs, Platelets
-Fatigue
-Frequent infections

Risk factors:
-Chemo
-Radiation
-benzene
-pesticides
-lead or mercury exposure

Tx:
-Supportive treatment

4

Describe Leukemia.

Literally "White Blood"

-Malignant disorder affecting the blood and tissue of the bone marrow, lymph system, and spleen.

-Unregulated proliferation and excessive accumulation of leukocytes (WBCs) in the bone marrow

-Results in overcrowding in bone marrow of WBC's

-Increased WBC's that are useless, RBCs normal but useless

5

What are the types of Leukemia? Describe.

Acute vs Chronic, Myeloid vs Lymphoid

Acute:
-Onset abrupt and immature cells

Chronic
-Slow onset
-More mature cells

1. Acute Myeloid
2. Chronic Myeloid
3. Acute Lymphoid
4. Chronic Lymphoid

6

What is Acute Myeloid Leukemia.
What are the risk factors?
What are the symptoms?
What is the treatment?

-Onset abrupt and immature cells w/ excessive proliferation
-Incidence peaks at age 60, but also affects children.
-Very ill, hospitalized for weeks

Risk factors:
-Radiation
-Benzene
-Chemo
-Down's Syndrome**

Symptoms:
-Anemia
-Infection
-Thrombocytopenia (DIC)

Tx:
-Induction therapy: aggressive chemo to kill myeloid cells, results in low to no cell counts (thrombocytopenia)

-Followed by Consolidation therapy (radiation or Rx to kill off remaining cells)

-Bone marrow Transplant/peripheral blood stem cell transplantation (goes into vein)

7

What can result from the Induction Therapy treatment for Acute Myeloid Leukemia?
Describe, and what is the treatment?

Tumor Lysis Syndrome:
-Cells are being destroyed releasing uric acid

Tx: allopurinol and fluid

8

What is Chronic Myeloid Leukemia?
What is specific to this illness?
What is the risk factor?
What are the symptoms?
What is the medication/treatment?

-Excessive development of mature neutrophils
-Peak age 45

-Philadelphia chromosome specific

Risk Factor: Radiation

Symptoms: they develop slowly*
-Weakness
-Fatigue
-Weight loss
-WBCs 100,000!!
-Some PT's Asymptomatic

Tx:
-imatinib mesylate

9

What is Thrombocytopenia?

low platelet count

10

Describe Acute Lymphocytic Leukemia.
What is a risk factor?
What are the symptoms?
What is the treatment?

-Most common type of leukemia in children.
-PT's will ALL tend to have better response to treatment than do PT's with AML.
-High remission rate! :)

Risk factor: Radiation

Symptoms:
-Leukocyte count high or low, but always high amount immature cells
-Organ infiltration = hepatosplenomegaly, bone pain, headache, and vomiting

Rx/Tx:
-steroids*
-imatinib*
-methotrexate
-intrathecal chemo
-Ommaya reservoir (implanted into ventricle to deliver medications)

11

What are the donor types of bone marrow transplant?

Allogenic (needs HLA matching)

Autologous

Syngeneic (identical twin of PT)

12

What is Graft vs Host complication from bone marrow transplants?

New cells of Donor attack PT

13

What is Chronic Lymphocytic Leukemia?
Describe.
Symptoms?
Treatment?

Malignant form of B lymphocytes

-Age 50-70
-Very few risk factors
-Most common form of Leukemia.

Sx:
-lymphadenopathy, unusually VERY large glands from Immune response

Tx:
-If early dx = no treatment
-chemo
-corticosteroids
-monoclonal antibody therapy w/ rituximab

14

What are Lymphomas?

Enlarged cancer filled lymph nodes

15

What does lymphatic system do?

Contains lymphocytes that eliminate bacteria

Antibodies manufactured by the lymph system

16

What are types of Lymphoma?

Hodgkin's

Non- Hodgkin's

17

What is Hodgkin's Lymphoma.
What's the age is usually happens?
What's the prognosis?
What is the cell that diagnoses it?
How it is diagnosed?
What is the suspected viral etiology?
What is the treatment?

Enlargement of 1-2 nodes that are PAINLESS
Excellent cure rate w/treatment
Incidence: early 20s and again after age 50

-Reed-Sternberg cell dx w/lymph node Biopsy.

-Epstein Barr virus suspected etiology

>Tx
combination chemotherapy:
-doxorubicin
-bleomycin
-vinblastine
-dacarbazine

Radiation

18

What is Non-Hodgkin's Lymphoma?
What is the treatment?

Lymphoid tissue becomes infiltrated with malignant cells that spread unpredictably.

-Multiple nodes

-Incidence increases w/age (average onset 50-60)

Tx:
-Interferon (biological modifier which boosts immune function to fight infection)
-Chemo
-Radiation

19

What is Multiple Myeloma?
How is it dx?
What are the manifestations?
Tx?

Malignant disease of plasma cells in bone marrow w/ destruction of bone.

-No cure

-Bone marrow biopsy - M protein and Bence-Jones protein

Symptoms:
-Bone pain
-Osteoporosis
-Fractures
-Anemia/Fatigue
-Risk for bleeding/infection

Tx:
-chemo
-corticosteroids
-radiation
-biphosphonates

20

What is a patient self determination act?

Your health care decision-making rights

21

What is an advance directive?

Written statement of PT's wishes regarding medical treatment, including a living will

22

How does a PT qualify for hospice?

Certified terminally ill by a physician and having a prognosis of 6 months or less

23

What leukemias is imatinib mesylate used for

Chronic myeloid and acute lymphiod leukemia