Questions and Answers
What characterizes chronic myelocytic leukaemia (CML)?
Which symptom is most likely associated with acute lymphoblastic leukaemia (ALL)?
What is a primary treatment phase in leukaemia management focused on achieving complete remission?
Which cell type is primarily responsible for humoral immunity?
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What is the expected average lifespan of red blood cells (RBCs)?
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In which leukaemia type is the Philadelphia chromosome most commonly associated?
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What is a potential consequence of leukocyte infiltration into systemic tissues?
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What is a significant risk factor for developing leukaemia?
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Which finding on a full blood count is most indicative of acute leukaemias?
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What is the recommended action when suctioning is unavoidable for a patient on medication that inhibits platelet function?
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Which of the following nursing interventions is appropriate to prevent falls in a patient with a bleeding risk?
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When caring for a patient with a high risk of prolonged bleeding, what is a crucial step to take?
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What is the priority nursing diagnosis for a client newly diagnosed with leukemia?
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Which of the following is NOT an appropriate method for controlling bleeding at the venipuncture site?
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Which of the following is NOT a necessary investigation for diagnosing chronic myelocytic leukemia?
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What type of toothbrush should a patient at risk of bleeding use for oral care?
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In managing a patient with potential constipation due to medication side effects, what should be prioritized?
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Study Notes
Introduction to Leukaemia
- Abnormal overproduction of leukocytes occurs primarily in the bone marrow.
- Immature white blood cells (WBCs), known as blast cells, proliferate and suppress normal bone marrow function.
- Main characteristics include:
- Replacement of normal bone marrow with malignant immature WBCs.
- Presence of abnormal immature circulating WBCs.
- Infiltration into organs such as the liver, spleen, and lymph nodes.
Causes and Risk Factors
- Etiology is often unknown; potential genetic damage leads to malignancy.
- Risk factors encompass:
- Genetic predispositions (e.g., Down syndrome).
- Viral infections (e.g., HTLV-1).
- History of aggressive chemotherapy affecting the immune system.
- Environmental exposures, including ionizing radiation, benzene, and certain medications.
Cell Types and Functions
- Key white blood cell types and their roles:
- Neutrophils: Prevent bacterial infections via phagocytosis.
- Monocytes: Differentiate into macrophages, important in fungal defense and immune surveillance.
- Eosinophils: Engage in allergic reactions by neutralizing histamine and digesting foreign proteins.
- Basophils: Contain histamine, crucial for hypersensitivity responses.
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Lymphocytes: Vital part of the immune system, with subtypes:
- T lymphocytes: Mediate cell-mediated immunity.
- B lymphocytes: Generate antibodies; develop into plasma cells.
- Plasma cells: Secrete immunoglobulins (antibodies).
- Erythrocytes (RBCs): Carry oxygen via hemoglobin; average lifespan is 120 days.
- Platelets (Thrombocytes): Essential for blood coagulation; average lifespan is 10 days.
Classification of Leukaemias
- Classifications are based on acuity and cell types:
- Acute Leukaemias: Rapid onset with immature cells; untreated often fatal within weeks.
- Chronic Leukaemias: Slower progression with mostly mature leukocytes; generally better prognosis.
- Lymphocytic (Lymphoblastic): Affects immature lymphocytes.
- Myelocytic (Myeloblastic): Involves myeloid stem cells, impacting development of blood cells.
- Types include acute myeloblastic, chronic myelocytic, acute lymphoblastic, and chronic lymphocytic leukaemia.
Types of Leukaemia
Acute Myeloblastic Leukaemia (AML)
- Characterized by excess myeloblast proliferation and hyperplasia of bone marrow and spleen.
- Symptoms include fever, infections, bleeding, and weight loss.
- Diagnoses reveal immature blast cells and thrombocytopaenia.
Chronic Myelocytic Leukaemia (CML)
- Result of myeloid stem cell mutation, often linked to the Philadelphia chromosome translocation.
- Symptoms can be mild but include fatigue and splenomegaly.
- Exhibits three phases: chronic, transformation, and terminal blast crisis.
Acute Lymphoblastic Leukaemia (ALL)
- Rapidly proliferates precursor B or T lymphocytes; common in children.
- Symptoms include headaches, vomiting, and pain due to organ infiltration.
Chronic Lymphocytic Leukaemia (CLL)
- Accumulation of abnormal, mature lymphocytes, predominantly B lymphocytes.
- Manifestations include fatigue, infections, and abdominal pain.
Diagnostic Investigations
- Full blood count may show a normal leukocyte count with decreased normal cell percentages.
- Bone marrow aspiration/biopsy assesses disease characteristics and extent.
- Lumbar puncture may evaluate central nervous system involvement, particularly for ALL.
Treatment Approaches
- Primarily involves chemotherapy, with possible radiation and stem cell transplantation.
- Phases of chemotherapy include induction, intensification, CNS prophylactic, and maintenance.
Nursing Diagnoses and Management
- Priority nursing diagnoses may include risk for infection and impaired physical mobility due to isolation.
- Nursing management focuses on preventing and managing infections and bleeding, effective pain control, and maintaining nutrition and physical activity.
Complications Prevention
- Perform oral care with soft-bristled toothbrushes; no flossing allowed.
- Avoid medications that inhibit platelet function and use electric razors for shaving.
- Apply caution during venipuncture and control any bleeding with direct pressure.
Multiple Choice Questions Insights
- Recognizing risk for infection as the priority nursing diagnosis for newly diagnosed leukaemia patients.
- Understanding necessary diagnostic investigations for conditions like chronic myelocytic leukaemia, including blood culture and bone marrow aspiration.
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Description
This quiz explores the abnormal production of leukocytes, focusing on leukemia, its effects on the bone marrow, and the infiltration of other organs. Understand the implications of immature white blood cells in the context of nursing care. Test your knowledge on identifying and managing this critical condition.
