EAQ- Lewis Med Surg CH.31, Nursing Management: Hematologic Problems- Lymphomas

A patient is in a limited stage of cutaneous T-cell lymphoma. Which treatment administered by the oncology nurse would be most beneficial for this patient?

1. Phototherapy

2. α- interferon therapy

3. Topical chemotherapy

4. Oral bexarotene therapy

3. Topical chemotherapy

Topical chemotherapy is beneficial in a patient who is in a limited stage of cutaneous T-cell lymphoma. Phototherapy, α- interferon therapy, and oral bexarotene therapy are used to treat diffuse cancer.

A patient has refractory lymphoma and has not had success with the current treatment regimen. For which therapy does the nurse prepare the patient to treat this aggressive lymphoma?

1. Vertebroplasty

2. Chemotherapy

3. Radiation therapy

4. Hematopoietic stem cell transplantation (HSCT)

4. Hematopoietic stem cell transplantation (HSCT)

Hematopoietic stem cell transplantation (HSCT) is used to treat aggressive or refractory lymphoma via the transplantation of multipotent hematopoietic stem cells. Vertebroplasty is performed to support degenerative vertebrae in multiple myeloma disease. Chemotherapy with corticosteroids is used to treat multiple myeloma. Radiation therapy is used to treat non-Hodgkin's lymphoma.

A patient diagnosed with high-grade lymphoma complains of fever, night sweats, and weight loss. Which medication administered by the nurse may have a positive outcome for the patient?

1. Prednisone

2. Vincristine

3. Mitoxantrone

4. Cyclophosphamide

1. Prednisone

Fever, night sweats, and weight loss are B symptoms that occur in patients diagnosed with high-grade lymphoma. Prednisone is an aggressive chemotherapeutic agent used to treat high-grade lymphoma. Vincristine, mitaxantrone, and cyclophosphamide are used in low-grade or indolent therapy to treat non-Hodgkin's lymphoma.

A nurse is assessing a patient diagnosed with Hodgkin's lymphoma. The patient reports fever, night sweats, and weight loss. On examination, the nurse finds that the lymph nodes above and below the diaphragm are involved. What clinical stage of the patient's disease do these symptoms indicate in this patient?

1. Stage IIIA

2. Stage IIIB

3. Stage IVA

4. Stage IVB

2. Stage IIIB

Because lymph nodes both above and below the diaphragm are involved, the patient is in stage III of the disease. The letter A indicates the absence of systemic symptoms and the letter B indicates their presence. Because the patient presents with systemic symptoms such as fever, night sweats, and weight loss, the patient is in stage IIIB. If the patient did not have any systemic symptoms, the stage of the disease would have been stage IIIA. In Stage IV, other internal organs also get involved apart from the diaphragm. Stages IVA and IVB indicate the absence and presence of systemic symptoms respectively.

Which statement is true regarding non-Hodgkin's lymphoma?

1. Non-Hodgkin's lymphoma is localized to regional nodes.

2. Non-Hodgkin's lymphoma involves common B symptoms.

3. Non-Hodgkin's lymphoma has rare extranodal involvement.

4. Non-Hodgkin's lymphoma originates from natural killer lymphocytes.

4. Non-Hodgkin's lymphoma originates from natural killer lymphocytes.

Non-Hodgkin's lymphoma originates from immune cells such as natural killer lymphocytes. Non-Hodgkin's lymphoma is disseminated. Non-Hodgkin's lymphoma is characterized by 40 percent B symptoms and common extra-nodal involvement.

The nurse is caring for a patient, who is prescribed rituximab. Which condition should the nurse check in the patient's history prior to administering the medication?

1. Hepatitis

2. Migraine attack

3. Vitamin D deficiency

4. Vitamin A deficiency

1. Hepatitis

Rituximab is used to treat Hodgkin's lymphoma. The nurse should check for hepatitis before administering the medication because this drug may reactivate hepatitis.

The oncology nurse is administering a chemotherapeutic agent to a patient with relapsed Hodgkin's lymphoma. Which medication administered will have the best outcome for this patient?

1. Fludarabine

2. Mitoxantrone

3. Cyclophosphamide

4. Brentuximab vedotin

4. Brentuximab vedotin

Brentuximab vedotin is the recommended drug used to treat relapsed or refractory Hodgkin's lymphoma disease by releasing an agent that disrupts the microtubule network. Fludarabine, mitoxantrone, and cyclophosphamide are used as combination chemotherapy to treat non-Hodgkin's lymphoma.

The nurse is caring for a patient with suspected non-Hodgkin's disease. For what diagnostic testing will the nurse prepare the patient?

1. Lumbar puncture

2. Peripheral blood analysis

3. Bone marrow examination

4. Magnetic resonance imaging (MRI)

4. Magnetic resonance imaging (MRI)

An MRI scan is used to diagnose non-Hodgkin's disease and to rule out central nervous system or bone marrow infiltration. A lumbar puncture is used to detect leukemia cells outside of the blood and bone marrow. Peripheral blood analysis is used to diagnose Hodgkin's lymphoma. Bone marrow examinations are used to diagnose multiple myeloma and leukemia.

While collecting the vital signs of a patient with lymphoma, the nurse identifies a blood pressure of 80/60 mm Hg and an irregular cardiac rhythm. Which medication does the nurse suspect is causing the condition?

1. Iron

2. Rituximab

3. Azacitidine

4. Zoledronic acid

2. Rituximab

A blood pressure of 80/60 mm Hg indicates hypotension and an irregular heartbeat is a sign of a cardiac arrhythmia. Rituximab may cause side effects such as hypotension and cardiac arrhythmia in patients with lymphoma. Zoledronic acid may cause renal toxicity when given intravenously. Azacitidine may cause side effects such as myelosuppression, nausea, vomiting, and diarrhea. Intravenous iron preparation may cause allergic reactions.

A patient with non-Hodgkin's lymphoma (NHL) develops tumor lysis syndrome. For which complication should the nurse monitor?

1. Jaundice

2. Bone pain

3. Paraplegia

4. Renal failure

4. Renal failure

Renal failure is a nonspecific manifestation of non-Hodgkin's lymphoma that may occur in patients due to tumor lysis syndrome. Jaundice, bone pain, and paraplegia are unrelated to tumor lysis syndrome

A patient is treated with chemotherapy for Burkitt's non-Hodgkin's lymphoma (NHL). For what complication should the nurse monitor the patient?

1. Renal dysfunction

2. Tumor lysis syndrome

3. Peripheral neuropathy

4. Fluid electrolyte imbalances

2. Tumor lysis syndrome

A patient undergoing chemotherapy for Burkitt's non-Hodgkin's lymphoma (NHL) is at a risk of developing tumor lysis syndrome and would require frequent laboratory studies and monitoring. Renal dysfunction, peripheral neuropathy, and fluid electrolyte imbalances are caused by myeloma proteins, which are associated with multiple myeloma.

While assessing a patient diagnosed with Hodgkin's lymphoma, the nurse identifies enlarged retroperitoneal nodes. For which complication should the nurse monitor?

1. Paraplegia

2. Liver dysfunction

3. Renal dysfunction

4. Superior vena cava syndrome

3. Renal dysfunction

Enlarged retroperitoneal nodes may cause palpable abdominal masses, which can interfere with renal function. Spinal cord compression causes paraplegia. If Hodgkin's lymphoma begins to affect the liver, bilirubin levels will increase and the patient will suffer from jaundice. Superior vena cava syndrome can occur due to intrathoracic involvement.