communication needs if applicable splinting incision ICU Post op promote

communication needs if applicable  splinting incision  ICU  Post-op  promote ventilation  chest tubes  promote comfort  I&O  pneumonectomy  no chest tubes  position on back, operative side  check for mediastinal shift Discharge  arm exercises  wound care, s/s infection  follow-up radiation/chemotherapy Radiation and chemotherapy  palliation for pain control

Leukemia Leukemia Types of Leukemia Treatments Nursing process  Leukemia “White blood”  Group of chronic malignant disorders of WBCs/ precursors  replacement of bone marrow by malignant, immature, circulating WBCs  infiltration of cells into liver, spleen, lymph nodes Incidence and Risk factors  Adult: 10 times more frequent than children  Genetic: Down syndrome  Environmental: exposure to cigarette smoking, benzene chemicals in gasoline, ionizing radiation Pathophysiology  Stem cell malignancy: accumulate in bone marrow  Immature cells replace normal hematopoietic elements  Results in severe anemia, splenomegaly, and bleeding difficulties  infiltrate to CNS, testes, GI tract, lymph nodes, liver, spleen Classifications  Acute: acute onset, rapid disease progression, immature blast cells  Chronic: gradual onset, prolonged course, abnormal mature cells  Lymphocytic: immature lymphocytes/ precursor bone marrow cells  Myeloid: myeloid stem cells, decreased maturation of granulocytes RBCs and thrombocytes Type of Leukemia  Acute lymphocytic (ALL)  Chronic lymphocytic (CLL)  Acute myeloid (AML)  Chronic myeloid (CML) Acute lymphocytic (ALL)  Myeloblast (precursors of granulocytes) proliferation and bone marrow/spleen hyperplasia  Common in older adults  Neutropenia (severe infection) and thrombocytopenia (bruising, hematuria, GI bleeding)  Chemotherapy, SCT Chronic Myeloid Leukemia  Abnormal proliferation of all bone marrow elements  Onset 30, 40, or 50 years  Chromosome abnormality (Philadelphia chromosome), translocation of chromosome 22 to 9  Terminal blast crisis-later progression to acute leukemia with blast cell proliferation and skin, lymph node, bone, CNS infiltration  Interferon alpha: chemotherapy, SCT Acute Lymphocytic Leukemia  Malignant immature B cells (lymphoblasts) proliferate in bone marrow  Thromobocytopenia, leukopenia and anemia  Chemotherapy: complete remission in 80% of adults  Chemotherapy; BMT, or SCT Chronic Lymphocytic Leukemia  Abnormal, mature, B lymphocyte proliferation in bone marrow, peripheral blood, body tissues  Older adults (65 and older)  Often requires no treatment; chemotherapy, BMT Diagnosis  CBCD : evaluates cell counts, H&H number, distribution, size and shape of WBCs  Plt: identify thrombocytopenia and bleeding risk  Bone marrow examination: identify cell marrow information, type of erythropoiesis, maturity of erythropoietin and leukopoietic cells Chemotherapy  Single agent or combination  Induction phase : high doses to eradicate leukemic, cells  Colony stimulating factors: