Nursing care for Leukemia

Summary

In this video, Professor D covers leukemia, explaining its definition, types, and impact on the blood and immune systems. He outlines the difference between acute myelogenous leukemia (AML), which mostly affects adults, and acute lymphocytic leukemia (ALL), more common in children. The video discusses leukemia's effects, such as increased immature white blood cells, bone marrow failure, and the associated risks of infection, anemia, and bleeding. Professor D also offers nursing interventions, diagnostic methods, and tips for managing chemotherapy side effects. He emphasizes patient independence, mental health, and a multi-disciplinary approach to treatment.

Takeaways

• 🔔 The presenter encourages viewers to like, subscribe, and engage with the video for better channel support and future updates.
• 💉 Leukemia is a malignant disorder affecting blood, bone marrow, lymph system, and spleen, leading to high risks of infections, anemia, and bleeding.
• 🦠 Leukemia involves an increase in immature white blood cells (WBCs) that do not function properly, taking up space that should be occupied by healthy cells.
• 📊 Chronic leukemias develop slowly and affect more mature WBCs, while acute leukemias have a sudden onset with more serious symptoms.
• 👩‍⚕️ Acute Myelogenous Leukemia (AML) commonly affects adults, causing abrupt, serious infections and abnormal bleeding due to overcrowding of bone marrow by myeloblasts.
• 👶 Acute Lymphocytic Leukemia (ALL) primarily affects children, with key symptoms including fever, CNS involvement, and neurological issues like increased intracranial pressure.
• 🦴 Bone marrow failure in leukemia leads to overcrowding by abnormal cells, reducing normal blood cell production and causing anemia, infections, and bleeding issues.
• 🧬 Leukemic cells infiltrate other organs, potentially causing splenomegaly, hepatomegaly, bone pain, and other organ-related issues, including life-threatening blood thickening (leucostasis).
• 🧑‍⚕️ Diagnosis of leukemia primarily involves peripheral blood evaluation and bone marrow examination, followed by treatment aimed at achieving remission, usually with chemotherapy.
• 👨‍👩‍👧‍👦 An inter-professional team, including oncology specialists, dietitians, psychiatrists, and social workers, is essential for managing the medical, emotional, and financial aspects of leukemia care.

Q & A

What is leukemia, according to the script?

Leukemia is a group of malignant disorders affecting the blood, blood-forming tissues of the bone marrow, lymph system, and spleen. It involves the proliferation of immature white blood cells (WBCs), which are non-functional and take up space that could be occupied by healthy red blood cells (RBCs) and platelets.

Why are patients with leukemia at high risk for infections?

Patients with leukemia are at high risk for infections because their bone marrow produces an excessive number of immature white blood cells, which are ineffective at fighting off infections. This leads to immunosuppression and makes the patient vulnerable to infections.

How does leukemia lead to anemia and bleeding tendencies?

Leukemia leads to anemia because the proliferation of immature white blood cells crowds out the space needed for the production of red blood cells, which carry oxygen. It causes bleeding tendencies because the bone marrow also fails to produce enough platelets, which are necessary for clotting.

What is the difference between acute myelogenous leukemia (AML) and acute lymphocytic leukemia (ALL)?

AML primarily affects adults, has an abrupt and dramatic onset, and leads to serious infections and abnormal bleeding due to uncontrolled proliferation of myeloblasts. ALL, on the other hand, is more common in children, and symptoms can be either abrupt or gradual. ALL frequently involves CNS manifestations, such as leukemic meningitis, and causes fatigue, weakness, and bleeding.

What are some clinical manifestations of leukemia?

Clinical manifestations of leukemia include anemia, immunosuppression, fatigue, weakness, bleeding tendencies, and CNS involvement (especially in ALL). The bone marrow becomes overcrowded with abnormal cells, leading to decreased production of healthy blood cells. Leukemic cells may also infiltrate other organs, causing issues like splenomegaly, hepatomegaly, and lymphadenopathy.

What diagnostic methods are used to confirm leukemia?

Peripheral blood evaluation and bone marrow examinations are the primary diagnostic methods used to diagnose and classify leukemia. These tests help determine the presence and type of leukemia.

Why is chemotherapy a key treatment for leukemia, and what are its side effects?

Chemotherapy is a mainstay treatment for leukemia because it targets and kills rapidly dividing cancer cells. However, it can also damage healthy cells, leading to side effects such as mucositis, stomatitis, nausea, vomiting, diarrhea, constipation, alopecia, and cognitive changes like 'chemo brain.'

What interventions can help manage the side effects of chemotherapy in leukemia patients?

Interventions to manage chemotherapy side effects include: assessing oral mucosa for lesions, providing nutritional supplements, recommending soft and bland foods, avoiding irritating or spicy foods, administering antiemetics before chemotherapy, encouraging fluid intake for diarrhea, and advising the use of wigs or scarves for hair loss.

What are the nursing priorities for patients with leukemia?

Nursing priorities include maximizing the patient’s physical functioning, educating the patient about the temporary nature of acute side effects from treatment, promoting independence, and encouraging discussions about quality-of-life issues and long-term care planning.

How does the inter-professional team support the care of leukemia patients?

An inter-professional team, including psychiatrists, oncology specialists, case managers, dietitians, chaplains, and social workers, collaborates to address the physical, emotional, spiritual, and social needs of leukemia patients. This team ensures comprehensive care and support, particularly in managing side effects, emotional distress, financial issues, and transitions in care.