Battle Against Leukemia

8/12/2019 Battle Against Leukemia

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Ongoing Fight

Against

LEUKEMIANURSING CARE MANAGEMENT

LEA FOY-OS CAPILI, RN, USRN, MAN


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Quality cancer care is likened to

that of a mother's gift of herself

for the sick child - it is the givingof total understanding and

support to the cancer patient with

love and compassion.


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Out of ~ 3300(IARC estimate)expected childhood cancer newcases each year, only 1000 arecared for and the remaining 2000are neither diagnosed nortreated.

Leukemia and retinoblastoma

account approximately 60% ofthese cases.

only 20% attaining long-termsurvival.

Among the 1000 children, 1 outof 5 receives treatment followinglocal gold standards

International Agency for Research in Cancer


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LEUKEMIAa malignant disorder of theblood and blood-formingorgans bone marrow, lymphnodes, and spleen), resultingin a loss of cell divisionregulation and maturation.


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1. Pertinent patient and family historyExposure to radiation for therapeutic

or non-therapeutic reasons

Exposure to chemicals

Cytotoxic drugs Benzene

Chloramphenicol

Phenylbutazone

Genetic abnormalities

Viral exposures


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2. Physical examinationOral cavity

Abdomen

Lymph node enlargement

Neurological

Musculoskeletal


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3. Evaluation of Laboratory Data

Hematocrit and hemoglobinlevels

WBC count with abnormaldifferential

Platelet count

CSF analysis

Liver function test values


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Potential for injury relatedto easy bruising or

bleeding tendencies.


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Impaired socialinteraction related to

prolonged hospitalization.


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Potential for impaired skinintegrity due to skin

infiltration of parenteral

anticancer drugs.


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Susceptibility to infectionrelated to ineffective

defense mechanisms.


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Alteration in nutrition:less than body

requirement due to

anorexia or vomiting.


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Potential for impairedrenal functions related to

nephrotoxic effects of

chemotherapy.


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Body image disturbancerelated to side effects of

some anticancer drugs.


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LEUKOSTASISAssess neurological status for

signs and symptoms of bleedingevery four hours

Institute additionalenvironmental and personalsafety measures

Assess for changes in respiratory

and status indicative of variousthrombosis


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INFECTIONMaintain patients skin integrity, sleep

and nutrition

Decrease invasive procedures

Provide private room

Prevent exposure to any person withviral or bacterial infections

Instruct patient on proper hygiene Patient and caregivers should practice

meticulous hand washing


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DISSEM INATED INTRAVASCULAR

COAGULATION

Prevent injury

Decrease invasiveprocedures

Monitor laboratoryresults


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ORAL COMPLICATIONSProvide routine oral care

Instruct to use toothbrushwith soft bristles


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Consider:

1. Type of the leukemia and treatment2. Side effects manifestations

3. Self-care measures

4. Manifestations of recurrent diseases

5. Self-care skills

6. Support system7. Institutional policies

8. Referral services


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Freedom from injury and infection

Consumption of adequate calories balanced

among basic food groups

Intact skin and mucous membrane

Absence of abnormal bleeding

Adequate urine output negative for occult

blood

Decreased discomfort and absence of pain

High self-esteem

Compliance to prescribed treatment


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QUALITYCANCER CARE


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1. Comfort

2. Safety3. Nutrition

4. Oral and skin care

5. Alleviation of pain6. On time medication

7. Respecting

8. Recreation and relaxation periods


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9. Respecting silence

10.Clarification of personal and family

values

11.Spiritual dimensions of prayer and

ritualistic practices

12.Constancy of presence and

congruence between what you sayand do.

13.Privacy and autonomy of the patient.

14.Friendship and collegiality.15.Have a parental heart and attitude.


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DAME CECILY SAUNDERS:

You matter because you are you!

You matter to the last moment o f

your l ife,And we w i ll do al l we can,

Not on ly to help you d ie in peace,

But also to l ive unt i l you die.

Battle Against Leukemia

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