Case Study on Onco Nursing ALL

7/25/2019 Case Study on Onco Nursing ALL

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Case Study: Acute Lymphocytic

Leukemia

Presented by:

Cherrylle Anne N. CaparaMa. Theresa Salinda



IntroductionACUT L!MP"#C!TIC LU$MIA

a disease %here too many immaturelymphocytes &a type o' %hite blood cell( are'ound in the blood and bone marro%.

)acute* means that the leukemia pro+ress,uickly- and i' not treated- %ould probably'atal %ithin a 'e% months.

Lymphocytic means it deelops 'rom early&immature( 'orms o' lymphocytes



Patient/s Pro0le

• A 66-year-old female presented to the emergencydepartment with severe headache, dyspnea on exertionand body weakness.

• Patient AB is a vegetarian, non-smoker, and a non-drinker. er disease was diagnosed in the year of !"#".

• $ne day prior to admission, patient AB complains ofbody weakness and di%%iness. &o treatment orintervention given to the patient, '(st a mere observation.)ew ho(rs prior to admission, patient still complains ofbody weakness accompanied by severe headache anddiffic(lty of breathing.



12I3 4ISCUSSI#N #3 T"CAS

• Patients with ac(te lymphoblastic le(kemia *A++present with either symptoms relating to directinfiltration of the marrow or other organs by

le(kemic cells or symptoms relating to thedecreased prod(ction of normal marrowelements.

• )ever is one of the most common symptoms of A++, and patients with A++ often have feverwitho(t any other evidence of infection whichwas experienced by the client.



• he was diagnosed with A++ last arch

!"#" at t. +(ke/s hospital at anila. he

had (ndergone 0 sessions of

chemotherapy.

• 1he client/s c(rrent admitting diagnosis is

2omm(nity Ac3(ired Pne(monia, A++.



Nursin+ Assessment

• physical signs of anemia, incl(ding pallor and cardiacflow m(rm(r.

• )ever

• crackles (pon a(sc(ltation of the l(ngs accompanied byyellowish-prod(ctive co(gh.

• Petechiae is present in her lower extremities andecchymoses was noted at her (pper extremities.

• Body weakness



Anatomy and Physiolo+y

• Bone marrow is the soft inner part of some bones, s(ch asthe sk(ll, sho(lder blades, ribs, pelvis, and bones in thespine.

• Blood stem cells go thro(gh a series of changes to makenew blood cells.

• 4ed blood cells carry oxygen from the l(ngs to all othertiss(es in the body, and take carbon dioxide back to the

l(ngs to be removed.

• Platelets are act(ally cell fragments made by a type of bonemarrow cell called a megakaryocyte. Platelets are importantin pl(gging (p holes in blood vessels ca(sed by c(ts or

br(ises.



cont.

• 5hite blood cells help the body fight infections.

• +ymphocytes are the main cells that make (p

lymphoid tiss(e, a ma'or part of the imm(nesystem.

• +ymphoid tiss(e is fo(nd in lymph nodes, thethym(s, the spleen, the tonsils and adenoids,and is scattered thro(gho(t the digestive andrespiratory systems and the bone marrow.



Pathophysiolo+y

• Any type of early blood-forming cell of the bone marrowcan t(rn into a le(kaemia cell.

• 1he le(kaemia cells co(ld reprod(ce 3(ickly, and might

not die when they sho(ld.

• nstead they s(rvive and b(ild (p in the bone marrow.$ver time, these cells spill into the bloodstream andspread to other organs, where they can keep other cellsfrom f(nctioning normally. 1he malignant cells of ac(telymphoblastic le(kemia *A++ are lymphoid prec(rsorcells *ie, lymphoblasts that are arrested in an earlystage of development.



• $ver time, these cells spill into thebloodstream and spread to other organs,where they can keep other cells from

f(nctioning normally.

• 1he malignant cells of ac(te lymphoblastic

le(kemia *A++ are lymphoid prec(rsorcells *ie, lymphoblasts that are arrested inan early stage of development.



• 1he lymphoblasts replace the normal marrowelements, res(lting in a marked decrease in theprod(ction of normal blood cells.

• 2onse3(ently, anemia, thrombocytopenia,and ne(tropenia occ(r to varying degrees.

• 1he lymphoblasts also proliferate in organs otherthan the marrow, partic(larly the liver, spleen,and lymph nodes.



LA1#2AT#2!54IA6N#STIC7AMINATI#NS

• 2B2 2748consolidated right

lower lobe of the

l(ngs• 5B29:.;• <B9#".0

• 219!=• P296;



#ther Labs and Ima+in+Studies

• Blood tests *2B2, Blood chemistry andcoag(lation tests

• Bone marrow tests

• 2hromosome testing

• +(mbar p(nct(re *spinal tap

• +ymph node biopsy



#ther Labs and Ima+in+Studies

• 7-rays

• 2omp(ted tomography *21 scan

• agnetic resonance imaging *4 scan

• >ltraso(nd

• <alli(m scan and bone scan



Nursin+ Care Plans

• neffective airway clearance related to retainedbronchial secretions

• yperthermia related to presence of pyrogens in thebody

• Alteration in 2omfort8 Ac(te Pain



Nursin+ 4ru+ Study

• Piperacillin-1a%obactam *ta%ovex

• )erronerv

• Paracetamol

• ydrocortisone

• ?(avent



Treatments o' Leukemia

• 2hemotherapy

• 1argeted therapy

• 4adiation therapy

• tem cell transplant

• (pportive therapy



Thank You

for

Listening

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