Neutropenia - Answer is a reduction in neutrophils or white blood cells i.e. when
ANC (absolute neutrophil count) is less than 1000cells/uL. A vital factor to observe
is the speedo of the decline of neutrophils cells. The faster the decline, the more
detrimental it is to the patient in terms of ...
GNRS556 MedSurg Focusing Reading Notes
Hematology, noncancer, leukemia, lymphoma,
breast--Questions and Correct Answers| Latest
Update
Neutropenia - Answer is a reduction in neutrophils or white blood cells i.e. when
ANC (absolute neutrophil count) is less than 1000cells/uL. A vital factor to observe
is the speedo of the decline of neutrophils cells. The faster the decline, the more
detrimental it is to the patient in terms of infection, sepsis, and death.
Discuss the causes of neutropenia - Answer Causes are from chemotherapy
treatment and immunosuppressive therapy for malignancies and autoimmune
disease. Neutropenia can also be caused by drugs, hematologic disorders,
autoimmune disorders, infections, and other disorders such as sepsis.
What are the complications related to neutropenia? - Answer Complications of
neutropenia include neutropenic colitis, infection, sepsis, and hemorrhage.
Discuss patient care management related to neutropenia. - Answer The priority in
patient care management for someone with neutropenia is preventing infection.
Determine the level of contact precaution needed as well as assessing the patient
for signs of infection, including fatigue and confusion. Teach outpatient patients
and families how to detect signs of infection and when to notify the provider
immediately. Screening visitors for any infections and ensuring foods are well
cooked. Teach patient, family, and guests about proper hand hygiene as well as
skincare and oral hygiene.
Acute Myelogenous
, Leukemia (AML) - Answer 15-20% in children, 80% adults; uncontrolled and rapid
production of myeloblasts; increase in tissue (hyperplasia) of bone marrow;
hematopoietic cells replaced by leukemic myeloblasts and infiltration of other
tissues; sudden onset of abnormal bleeding and infection; s/s include fatigue,
weakness, bleeding, anemia, mouth sores, fever, infection, sternal tenderness,
overgrowth of gum tissue (gingival hyperplasia), and hepatosplenomegaly.
With Chronic leukemia, therapy involves chemotherapy, corticosteroids,
monoclonal antibodies as well as blood and platelet transfusion due to a decrease
in RBC and platelets. Radiation therapy to reduce lymph nodes and possibly stem
cell therapy. With Acute leukemia, treatment will begin immediately due to the
quick progression of cancer and involves the killing of the leukemia cells with
hospitalization necessary at times; use of a various mixture of drugs; regular
blood and bone marrow tests are made to assess treatment progress.
Acute
Lymphocytic
Leukemia (ALL) - Answer Occurs between 2 and 5 and after 50; 20% of leukemia in
adults; small/immature B-cell originated lymphocytes produce rapidly in bone
marrow; usually patients experience fever at time of diagnosis; s/s may occur
suddenly with bleeding or fever or slowly with increased fatigue, weakness, bone
or joint pain and tendency to bleed.
Chronic
Myelogenous
Leukemia (CML) - Answer Increasingly abnormal production of neoplastic
granulocytes in bone marrow; move into surrounding blood and invade liver and
spleen; chronic stable phase then an acute vigorous phase termed blastic phase;
chronic phase lasts several years controlled with treatment; treated aggressively
with onset of blastic phase; s/s asymptomatic in beginning then fever, weakness,
joint and bone pain, weight loss, increase in sweating, splenomegaly and
tenderness in sternum.
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