Term
|
Definition
- wbc
- 4500-11000
- Neutrophil - 45-73
- lymphocyte - 20-40
- monocyte - 2-8
- eosinophil - 0-4
- basophil - 0-1
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Term
| Total WBC count indicates ? |
|
Definition
- response to a pathologic process
- shift left refers to an increase in neutrophils and immature neutrophils called bands
- can occur under stress
- acute bacterial infection
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Term
| Lymphocytes types ? increased d/t ? |
|
Definition
- t cells, b cells in viral infections
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Term
| Predisposing risk factors for leukemia ? |
|
Definition
- genetic - downs syndrome, fanconi anemia
- ionizing radiation - therapeutic / atomic
- chemicals / drugs - benzene, pesticides
- viral infection - Human t cell leukemia, epstein barr
- identical twin with leukemia
- first degree relative with CLL - chronic lympocytic leukemia
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Term
|
Definition
- are cancers that originate in the bone marrow or lymphatic tissues
- involve the uncontrolled growth of cells with similar functions and origins
- accumulation of malignant cells interferes with the bodys production of healthy blood cells
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Term
|
Definition
- leukemia
- hodgkin lymphoma
- non-hodgkin lymphoma
- myeloma
- myelodysplastic syndromes
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Term
|
Definition
- the balanced proliferation and maturation of blood cells (wbc) is altered and normal bone marrow is ultimately replaced by abnormal immature cells
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Term
|
Definition
- acute myeloid leukemia
- chronic myeloid leukemia
- acute lymphocytic leukemia
- chronic lymphocytic leukemia
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Term
|
Definition
- acute myeloid leukemia
- defect in stem cell that differentiate into all myeloid cells
- monocytes, granulocytes, erythrocytes, platelets
- all ages - peaks at 67
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|
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Term
|
Definition
- fever/infection
- weakness/fatigue
- bleeding tendencies
- pain from hepatomegaly/splenomegaly
- hyperplasia of gums - overgrowth of the gums
- bone pain
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|
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Term
|
Definition
- aggressive chemotherapy
- induction therapy - 1st in cancer treatment
- Bone marrow transplant(BMT)
- peripheral blood stem cell transplant(PBSCT)
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Term
|
Definition
- Chronic myeloid leukemia
- mutation of myeloid stem cell
- uncontrolled proliferation of cells
- >20yr, ↑age, mean is 55-60yrs
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Term
|
Definition
- asymptomatic initially
- malaise
- anorexia/weight loss
- SOB
- leukostasis
- confusion
- hepatomegaly/splenomegaly
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|
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Term
|
Definition
- imatinib mesylate - gleevac
- chemo
- BMT
- PBSCT
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Term
|
Definition
- chronic phase
- transformational
- blast crisis
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Term
|
Definition
- early stages
- mature cells / immature abnormal WBC are higher than normal
- lower levels than accelerated or blast phase
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|
|
Term
| Transformational phase of CML |
|
Definition
- may last from several months to several years
- may be no signs of leukemia
- night sweats
- weight loss
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|
|
Term
| Blast crisis stage of CML |
|
Definition
- occurs when more than 30% of the cells in the blood or bone marrow are blast cells
- tired
- fever
- splenomegaly
- death
|
|
|
Term
|
Definition
- acute lymphocytic leukemia
- uncontrolled proliferation of immature cells from lymphoid stem cell
- prognosis good for children
- survival drops with age
- 50% of adults survive
|
|
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Term
|
Definition
- leukemic cell infiltration is more common
- meningeal involvment
- pain
|
|
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Term
|
Definition
- monoclonal antibody therapy
- chemo
- BMT
- PBSCT
|
|
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Term
|
Definition
- is a white blood cell count above 100,000
|
|
|
Term
|
Definition
- Chronic lymphocytic leukemia
- malignant b lymphocytes
- most are mature
- may escape apoptosis - excessive accumulation
- common in adults over >55
- more men
- 2-14 year survival rate
|
|
|
Term
|
Definition
- lymphadenopathy
- hepatomegaly
- splenomegaly
- anemias
- thrombocytopenia
- fever
- sweats
- weight loss
|
|
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Term
|
Definition
- monoclonal antibody therapy
- chemo
|
|
|
Term
|
Definition
- leukocyte count
- ANC - absolute neutrophil count
- hematocrit
- platelets
- electrolytes
- cultures
|
|
|
Term
| Potential Nursing diagnosis ? |
|
Definition
- risk for bleeding and infection
- risk for impaired skin integrity
- impaired gas exchange
- impaired mucous membrane
- imbalanced nutrition
- acute pain
- hyperthermia
- fatigue
- activity intolerance
|
|
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Term
| Problems from Leukemia or Multiple myeloma |
|
Definition
- infection
- bleeding
- renal dysfunction
- tumor lysis syndrome
- nutritional depletion
- mucositis
- depression
|
|
|
Term
| Tumor Lysis Syndrome is ? |
|
Definition
- potentially fatal complication associated with radiation or chemo induced cell destruction of large rapidly growing cancers
- released intracellular metabolites causes
- electrolyte imbalances
- hyperkalemia
- hypocalcemia
- hyperphosphaemia
- hyperuricemia
- tmnt - rasburicose (elitek)
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|
|
Term
| Mylodysplastic syndrome is ? |
|
Definition
- group of disorders of myeloid stem cells that cause dysplasia
- over 60>yrs
|
|
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Term
|
Definition
- erythrocytes = macrocytic anemia
- leukocytes = ↑ infection
- platelets = bleeding tendencies
|
|
|
Term
|
Definition
- transfusions
- allogenic BMT
|
|
|
Term
|
Definition
- any age
- prior toxic exposure to chemicals
- chemo
- radiation
- complication 30% evolve into AML
|
|
|
Term
| Tmnt of Secondary MDS is ? |
|
Definition
- azacitidine (vidaza)
- decitabine (dacogen)
- help the marrow function more normally and may reduce the need for blood transfusions
|
|
|
Term
| Mucositis interventions ? |
|
Definition
- frequent gentle oral hygiene
- soft toothbrush
- sponge tip applicators
- rinse with NS, NS with baking soda, prescribed solutions
- perineal and rectal care
|
|
|
Term
|
Definition
- provide oral care
- analgesics before meals
- anti n/v meds
- provide small frequent meals soft
- low microbial diet
- supplements
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|
|
Term
|
Definition
- are cancers of lymphocytes
- wbc in the bone marrow and lymph nodes that fight infection and produce antibodies
- two types are:
- hodgkins lymphoma
- non hodgkins lymphoma
|
|
|
Term
|
Definition
- unicentric origin / reed-sternberg cell
- viral etiology
- early 20's and after 50
|
|
|
Term
| Signs of Hodgkins lymphoma |
|
Definition
- painless lymph node enlargement
- pruritis
- fever
- sweats
- weight loss
|
|
|
Term
| tmnt of hodgkins lymphoma ? |
|
Definition
- chemo
- radiation
- days 1-15 repeat every 4 week for 2-4 cycles
- A-doxorubicin(adrianmycin)
- B-bleomycin
- V-vinblastine
- D-dacarbazine
- may cause infertility/ sperm abnormalities.
|
|
|
Term
| Non-hodgkin lymphoma is ? |
|
Definition
- NHL
- lymphoid tissues become infiltrated with malignant cells that spread unpredictably
- ↑ with age - 50-60 yrs
- prognosis varies
|
|
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Term
|
Definition
- interferon
- chemotherapy
- radiation
|
|
|
Term
|
Definition
- stage I - single lymph node/localized involvement
- stageII - two+ lymph node regions on same side
- stageIII-several lymph node regions on both sides
- StageIV-involves extralymphatic tissue, ei bone marrow
|
|
|
Term
| complications of Hodgkins disease ? |
|
Definition
- immune dysfunction
- herpes infection
- aml mds NHL
- solid tumors
- hypothryoidism
- pericarditis/cardiomyopathy
- growth retardation
- infertility impotence
|
|
|
Term
|
Definition
- malignant disease of plasma cells in the bone marrow with destruction of bone
- d/t unregulated proliferation monoclonal plasma cells leading to ↓ bone marrow function and destruction of Bone tissue
- M protein
- bence-jones protein
|
|
|
Term
| Signs of multiple myeloma? |
|
Definition
- bone pain / osteoporosis / fx
- ↑ serum protein
- hypercalcemia
- renal damage / failure
- anemia - fatigue / weakness
- ↑ serum viscosity
- ↑ risk for bleeding / infection
|
|
|
Term
| complications of multiple myeloma or leukemia |
|
Definition
- infection
- bleeding
- renal dysfunction
- tumor lysis syndrome
- nutritional depletion
- mucositis
- depression
|
|
|
Term
|
Definition
- pamidronate disodium(aredia)
- zoledronic acid(zometa)
- tmnt choice for hypercalcemia of malignancy
- tmnt skeletal lesions/complications
- risk of osteonecrosis of the jaw with long term use
|
|
|
Term
|
Definition
- condition in which the WBC are fewer in # than normal
- agranulocytosis
- leukocyte count
- granulocyte count
- neutropenia
|
|
|
Term
|
Definition
- is a potentially fatal condition in which there is almost complete absence of polymorphonuclear leukocytes
|
|
|
Term
| Leukocyte / granulocyte count ? |
|
Definition
- <5000
- <2000
- is abnormal and may signal a generalized bone marrow disorder
|
|
|
Term
|
Definition
| an abnormally low absolute neutrophil count which is associated with an increased risk of infection |
|
|
Term
| Neutropenia precautions ? |
|
Definition
- no colds/ sore throat to care for pt
- neutropenic pts before other pts
- private room
- no fresh flowers
- change water every shift
- no salads and unpeeled fresh fruit/veggies
- avoid suppositories enemas rectal temp
|
|
|
Term
|
Definition
- imatinib mesylate
- blocks signals in leukemic cells that express philli chromosomes
- s/e - cerebral hemorrhage, hemorrhage, neutropenia, thrombocytopenia, anemia
|
|
|
Term
| Short term Corticosteroid complications ? |
|
Definition
- F/E - fluid retention, Na retention, K+ loss, HTN
- endocrine - ↓ carbohydrate tolerance
- neurologic - HA
- MS - muscle weakness
- psycologic - depression, euphoria, mood swings, insomnia, pyschosis
|
|
|
Term
| Long term Corticosteroid complications ? |
|
Definition
- endocrine - ↓ adrenocortical activity, ↓carbohydrate tolerance, ↓ growth rate
- metabolic - protein catabolism(Neg Nit Bal)
- GI - gastritis, ulcerative esophagitis, pancreatitis
- MS - ↓ muscle mass, osteoporosis
- Neurologic - vertigo, ↑ICP, seizures
- ophthalmic - cataracts, gluacoma, exophthalmos
- dermatologic - impaired wound healing, ecchymoses ↓ skin thickness
- immunologic - ↓response to infection, masked signs to infection, ↑ risk for opportunistic infection
|
|
|
Term
|
Definition
- bone marrow transplant
- for hematological cancers that effect the marrow or solid tumors, tx with chemo dosage that ablates the bone marrow
- typse of BMT
- allogenic - donor
- autologus - patient
- syngeneic - identical twin
|
|
|
Term
|
Definition
- cytoreduction
- infusion of the bone marrow cells
- engraftment
- hematologic normalization occurs in 2-3 months
|
|
|
Term
|
Definition
- tmnt with high doses of chemo and or total body radiation to destroy the bone marrow
|
|
|
Term
| infusion of the bone marrow cells |
|
Definition
- IV over a period of 20-30 minutes.
- pts may report N/V and HA during infusion
|
|
|
Term
|
Definition
- usually occurs in 1-2 weeks as AEB by the presence of hematopoietic elements in the bone marrow
- in 3-4 weeks the peripheral blood counts begin to rise
|
|
|
Term
|
Definition
- peripheral blood stem cell transplant
- aka apheresis or leukapheresis
- a process to obtain PBSC for transplantation
- meds given 4/5 days before to ↑ stem cells in blood
- dialysis like process collects stem cells
- 4-6 hrs
|
|
|
Term
|
Definition
- Graft vs Host disease
- Venous occlusive disease
- Acute toxicities
- High risk of sepsis and bleeding (death)
|
|
|
Term
| Graft vs Host disease is ? |
|
Definition
- occurs when the T lymphocytes from the tranplanted donor marrow become activated and mount an immune response against the recipients tissues
|
|
|
Term
| Venous occlusive disease is ? |
|
Definition
- a vascular injury to the liver from the high dose chemo occuring in the 1st 100 days.
|
|
|
Term
|
Definition
- cyclosporine - immunosuppresive
- methotrexate - immunosuppresive
- steroids - limited long term
- antithymocyte globulin - immunosuppresive
|
|
|
Term
|
Definition
- human leukocyte antigen testing
- use of meds
- irradiation of blood products
- elimination of T cells from the donors marrow before infusion
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