Chapter 30: Management of Patients With Hematologic Neoplasms

An oncology nurse is providing health education for a client who has recently been diagnosed with leukemia. What should the nurse explain about commonalities between all of the different subtypes of leukemia?

The different leukemias all involve unregulated proliferation of white blood cells.

A nurse is caring for a patient who has a diagnosis of acute leukemia. What assessment most directly addresses the most common cause of death among patients with leukemia?

Monitoring for Infection

An oncology nurse is caring for a patient with multiple myeloma who is experiencing bone destruction. When reviewing the patients most recent blood tests, the nurse should anticipate which imbalance?

Hypercalcemia

A nurse is planning the care of a patient who has been admitted to the medical unit with a diagnosis of multiple myeloma. In the patients care plan, the nurse has identified a diagnosis of Risk for Injury. Which pathophysiologic effect of multiple myeloma most contributes to this risk ?

Decreased bone density

A patient with advanced leukemia is poorly to treatment. The nurse finds the patient tearful and trying to express his feelings, but he is clearly having difficulty. What is the nurse's most appropriate action?

Ask if he would like you to sit with him while he collects his thoughts

A nursing student is caring for a patient with acute myeloid leukemia who is preparing to undergo induction therapy. In preparing a plan of care for this patient, the student should assign the highest priority to which nursing diagnoses?

Risk for infection

A 77 year-old male is admitted to a unit with a suspected diagnosis of acute myeloid leukemia (AML). When planning this patients care, the nurse should be aware of what epidemiologic fact?

Five- year survival for patients over 75 years old is less than 2%

A 35-year-old male is admitted to the hospital complaining of severe headaches, vomiting, and testicular pain. His blood work shows reduced numbers of platelets, leukocytes, and erythrocytes, with a high proportion of immature cells. The nurse caring for this patient suspects a diagnosis of what?

Acute lymphocytic leukemia (ALL)

A patient with leukemia has developed stomatitis and is experiencing a nutritional deficit. An oral anesthetic has consequently been prescribed. What health education should the nurse provide to the patient?

Chew with care to avoid inadvertently biting the tongue.

A patient diagnosed with acute myelogenous leukemia has just been admitted to the oncology unit. When writing this patient's care plan, what potential complication should the nurse address?

B. Hemorrhage

An emergency department nurse is triaging a 77-year-old man who presents with uncharacteristic fatigue as well as back and rib pain. The patient denies any recent injuries. The nurse should recognize the need for this patient to be assessed for what health problem?

Non-Hodgkin lymphoma

A home health nurse is caring for a patient with multiple myeloma. Which of the following interventions should the nurse prioritize when addressing the patient's severe bone pain?

Helping the patient manage the opioid analgesic regimen

A nurse is caring for a patient with Hodgkin lymphoma at the oncology clinic. The nurse should be aware of what main goal of care? Cure of the disease

Cure of the disease

A patient with non-Hodgkins lymphoma is receiving information from the oncology nurse. The patient asks the nurse why she should stop drinking and smoking and stay out of the sun. What would be the nurses best response?

It's important to reduce other factors that increase the risk of second cancers.

An adult patient has presented to the health clinic with a complaint of a firm, painless cervical lymph node. The patient denies any recent infectious diseases. What is the nurses most appropriate response to the patients complaint?

Promptly refer the patient for medical assessment

A nurse practitioner is assessing a patient who has a fever, malaise, and a white blood cell count that is elevated. Which of the following principles should guide the nurse's management of the patient's care?

Infection is the most likely cause of the patients change in health status.

Diagnostic testing has resulted in a diagnosis of acute myeloid leukemia (AML) in an adult patient who is otherwise healthy. The patient and the care team have collaborated and the patient will soon begin induction therapy. The nurse should prepare the patient for which of the following?

An aggressive course of chemotherapy

A patient with a diagnosis of acute myeloid leukemia (AML) is being treated with induction therapy on the oncology unit. What nursing action should be prioritized in the patients care plan?

Protective isolation and vigilant use of standard precautions

A nurse is caring for a patient who has been diagnosed with leukemia. The nurses most recent assessment reveals the presence of ecchymoses on the patient's sacral area and petechiae in her forearms. In addition to informing the patients primary care provider, the nurse should perform what action?

Check the client's most recent platelet level.

A 60-year-old patient with chronic myeloid leukemia will be treated in the home setting and the nurse is preparing appropriate health education. What topic should the nurse emphasize?

The importance of adhering to the prescribed drug regimen

A older adult patient is undergoing diagnostic testing for chronic lymphocytic leukemia (CLL). Which assessment finding is certain to be present if the patient has CLL?

Increased lymphocyte levels

A patient has been found to have an indolent neoplasm. The nurse should recognize what implication of this condition?

The patient faces a significant risk of malignancy

A nurse is caring for a patient who is being treated for leukemia in the hospital. The patient was able to maintain nutritional status for the first few weeks following her diagnosis but is now exhibiting early signs and symptoms of malnutrition. In collaboration with the dietitian, the nurse should implement what intervention?

Provide the patient with several small, soft- textured meals each day

A patient who is undergoing consolidation therapy for the treatment of leukemia has been experiencing debilitating fatigue. How can the nurse best meet this patients needs for physical activity?

Assist the patient to a chair during awake times, as tolerated.

An oncology nurse recognizes a patient's risk for fluid imbalance while the patient is undergoing treatment for leukemia. What relevant assessments should the nurse include in the patient's plan of care? Select all that apply.

Monitoring the patients electrolyte levels, Measuring the patient's weight on a daily basis, Measuring and recording the patients intake and output, Auscultating the patients lungs frequently

After receiving a diagnosis of acute lymphocytic leukemia, a patient is visibly distraught, stating, "I have no idea where to go from here." How should the nurse prepare to meet this patient psychosocial needs?

Assess the client's specific needs for education and support.

A patient has completed the full course of treatment for acute lymphocytic leukemia and has failed to respond appreciably. When preparing for the patient's subsequent care, the nurse should perform what action?

Identify the patient's specific wishes around end care

Following an extensive diagnostic workup, an older adult patient has been diagnosed with a secondary myelodysplastic syndrome (MDS). What assessment question most directly addresses the potential etiology of this patients health problem?

Were you ever exposed to toxic chemicals in any of the jobs that you held?

A patient with myelodysplastic syndrome is being treated on a medical unit. Which assessment finding should prompt the nurse to contact the patients primary care provider?

An oral temperature of 37.5°C (99.5°F)

A nurse is preparing health education for a patient who has received a diagnosis of myelodysplastic syndrome (MDS). Which of the following topics should the nurse prioritize?

Emergency management of bleeding episodes

A clinic patient is being treated for polycythemia vera and the nurse is providing health education. Which practice should the nurse recommend in order to prevent the complications of this health problem?

Avoiding tight and restrictive clothing on the legs

A clinic nurse is working with a patient who has a longstanding diagnosis of polycythemia vera. How can the nurse best gauge the course of the patients disease?

Follow the trends of the client's hematocrit

A nurse is planning the care of patient who has been diagnosed with essential thrombocythemia (ET). Which nursing diagnosis should the nurse prioritize when choosing interventions?

Risk for ineffective tissue perfusion

A nurse at a long-term care facility is amending the care plan of a resident who has just been diagnosed with essential thrombocythemia (ET). The nurse should anticipate the administration of what medication?

Hydroxyurea

A nurse is writing the care plan of a patient who has been diagnosed with myelofibrosis. What nursing diagnoses should the nurse address? Select all that apply.

Disturbed body image, Impaired mobility, Imbalanced nutrition: Less than body requirements, Risk for infection

An adult patient's abnormal complete blood count (CBC) and physical assessment have prompted the primary care provider to order a diagnostic workup for Hodgkin lymphoma. The presence of what assessment finding is considered diagnostic of the disease?

Reed-Sternberg cells

A young adult patient has received the news that the her treatment for Hodgkin lymphoma has been deemed successful and that no further treatment is necessary at this time. The care team should ensure that the patient receives regular health assessments in the future due to the risk of which complication?

Hematologic cancers

The clinical nurse educator is presenting health promotion education to a patient who will be treated for non-Hodgkin lymphoma on an outpatient basis. The nurse should recommend which of the following actions?

Avoiding highly crowded public places

A patient has a diagnosis of multiple myeloma and the nurse is preparing health education in preparation for discharge from the hospital. Which action should the nurse promote?

Close monitoring of urine output and kidney function

A nurse is caring for a patient whose diagnosis of multiple myeloma is being treated with bortezomib. The nurse should assess for what adverse effect of this treatment?

Peripheral neuropathy