LEUKEMIAS - LEUKEMIAS The term leukemia describes a...

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LEUKEMIAS The term leukemia describes a malignant disorder of the blood and lymph-forming tissues of the body. The blood’s cellular components originate primarily in the marrow of bones such as the sternum, iliac crest, and cranium. All blood cells begin as immature cells (blasts or stem cells) that differentiate and mature into RBCs, platelets, and various types of WBCs. In leukemia, many immature or ineffective WBCs crowd out the developing normal cells. As the normal cells are replaced by leukemic cells, anemia, neutropenia, and thrombocytopenia occur. Leukemia is acute when WBCs proliferate so rapidly that they lose the ability to regulate cell division and do not differentiate into mature cells. In the chronic forms of leukemia, the disease develops gradually. The type of leukemia is based on the predominant cell line that is affected. In adults, the most common of the acute leukemias is acute myelocytic leukemia, which affects any type of WBC other than lymphocytes. The most common of the chronic leukemias is chronic lymphocytic leukemia, which is characterized by an abnormal increase in lymphocytes. CARE SETTING Acute inpatient care on medical unit for initial evaluation and treatment typically 4–6 wk, then at the community level. RELATED CONCERNS Cancer Psychosocial aspects of care Transplantation: postoperative and lifelong needs Patient Assessment Database Data depend on degree/duration of the disease and other organ involvement. ACTIVITY/REST May report: Fatigue, malaise, weakness; inability to engage in usual activities, flu-like symptoms May exhibit: Muscle wasting Increased need for sleep, somnolence CIRCULATION May report: Palpitations May exhibit: Tachycardia, heart murmurs Pallor of skin, mucous membranes Cranial nerve deficits and/or signs of cerebral hemorrhage EGO INTEGRITY May report: Feelings of helplessness/hopelessness May exhibit: Depression, withdrawal, anxiety, fear, anger, irritability Mood changes, confusion ELIMINATION May report: Diarrhea; perianal tenderness, pain Bright red blood on tissue paper, tarry stools Blood in urine, decreased urine output May exhibit: Perianal abscess; hematuria FOOD/FLUID May report: Loss of appetite, anorexia, vomiting Change in taste/taste distortions Weight loss Pharyngitis, dysphagia May exhibit: Abdominal distension, decreased bowel sounds Splenomegaly, hepatomegaly; jaundice
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Stomatitis, oral ulcerations Gum hypertrophy (gum infiltration may be indicative of acute monocytic leukemia) NEUROSENSORY May report: Lack of coordination/decreased coordination Mood changes, confusion, disorientation, lack of concentration Dizziness; numbness, tingling, paresthesias May exhibit: Muscle irritability, seizure activity, uncoordinated movements PAIN/DISCOMFORT May report: Abdominal pain, headaches, bone/joint pain; sternal tenderness, muscle cramping May exhibit: Guarding/distraction behaviors, restlessness; self-focus RESPIRATION May report: Shortness of breath with minimal exertion
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LEUKEMIAS - LEUKEMIAS The term leukemia describes a...

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