Pathologic Conditions
- Definition: Cancer of the blood-forming tissues.
- Pathophysiology: Immature leukocytes (white cells) known as blasts overproduce and compete with normal white cells, red cells, and platelets as well as other body tissues for space and nutrition. The resultant decrease in normal blood elements results in infections (because of decreased normal white cells), anemia (because of decreased red cells), and bleeding tendencies (because of decreased platelets). Bone marrow and highly vascular organs are heavily infiltrated with the abnormal white cells.
- Etiology: Unknown. May be related to genetic abnormality or exposure to environmental factors such as radiation or toxic chemicals. Acute lymphoid leukemia (ALL) originates in the lymphatic system. Acute nonlymphoid leukemia (ANLL) or acute myelogenous leukemia (AML) originates in the bone marrow.
- Manifestations: Recurrent or lingering infection, fever, fatigue, pallor, anorexia, bleeding, bruising, petechiae, night sweats, bone and joint pain.
- Med Tx: Chemotherapy and possible bone marrow transplantation.
- Nsg Dx: Potential for infection, activity intolerance, potential for injury, pain, potential for wide range of psychosocial diagnoses.
- Nsg Care: Protect from and monitor for infection. Monitor closely for side effects of chemotherapy. Avoid administration of vesicant chemotherapy in veins that are near joints. Administer antiemetics before chemotherapy-induced nausea occurs. Coordinate care to permit periods of uninterrupted rest. Provide emotional support.
- Prognosis: Cure rate for childhood ALL is 60% and 50% for ANLL. More deaths are from infection than from leukemia itself.