Leukemia: Nursing Considerations and Management

SimpleNursing Editorial Team Aug 6, 2018

In today’s leukemia lecture, we’ll be talking about the basic treatments and interventions that primarily influence your client’s condition. The information that will be given here is critical in passing major nursing exams, especially the NCLEX®.

So, let’s figure out what are the things that you should focus on, especially in managing clients with leukemia.

Uncomplicated Pathophysiology

Leukemia treatment is done because the bone marrow is producing increased white blood cells (WBC), more than the usual, acceptable number. These white blood cells that are immaturely produced are pushing on the bone marrow which causes immense pain. Also, these WBCs are crowding out the other major blood components, mainly the red blood cells and the platelets.

Clinical Manifestations

Usually, hospitals would have a maximum of 10,000 WBCs for their laboratory report value. However, clients with leukemia would go as high as 30,000 WBCs. Therefore, the main clinical manifestation in terms of laboratory results is that everything else (platelets and red blood cells) would be low aside from the white blood cell count.

Nursing Management

There are a couple of nursing management and considerations that nurses have to keep in mind when taking care of a client with leukemia.

Radiation and Chemotherapy

These are primarily given to decrease the abnormally high number of white blood cells. Radiation and chemotherapy will technically restart the entire system of producing WBCs because they will wipe out the WBC population – the good and the bad ones.

White blood cells are considered as the soldiers or police officers of the body, and their main objective is to fight off illnesses and infections. Wiping out white blood cells through radiation and chemotherapy would mean that there will be no elements to protect the body from opportunistic viruses and bacteria that could immediately harm the system.

What to expect:

  1. White blood cell count can be less than one or two, resulting in a neutropenic client.
  2. A bone marrow transplant can be given to re-infuse stem cells that can reproduce adequate white blood cells to sustain and maintain the body’s immunity.
  3. Neutropenic precaution will be activated due to increased risk for infection.
    • Prophylactic antibiotics will be given.
    • Hand washing is a must for people who will come in contact with the client, especially families, and
    • Wearing of a mask is required to prevent transport of communicable diseases.
    • Limit visitation privileges.

NCLEX® Question

One favorite NCLEX® question regarding neutropenic precaution would be:

Are flowers and fruits allowed inside the room of a client with leukemia?

Answer: No, flowers and fruits are not allowed.

But, why?

Flowers and fruits go through a process that makes sure sanitation is maintained. This sanitation process sometimes involves chemicals and other harmful elements that, when exposed to a client with leukemia, would cause sickness.

Chemotherapy Reminders

A client who undergoes chemotherapy is technically killing off immature and healthy white blood cells. Some of the side effects of this procedure are:

  1. Alopecia or hair loss
  2. Non-production of epithelial cells inside the mouth that can cause sores and ports of entry
  3. The gastrointestinal lining will be compromised; therefore, inserting rectal thermometers are contraindicated.

That’s it for our leukemia lecture. Check out our other nursing topics on SimpleNursing website and YouTube channel.

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