Leukemia PATHOPHYSIOLOGY

LEUKEMIA
Leukemia is the distorted and uncontrolled proliferation of WBCs (leukocytes) and is the most
frequently occurring type of cancer in children.
PATHPOPHYSIOLOGY
(Acute Lymphoblastic Leukemia)
Predisposing factors: ETIOLOGY: Precipitating factors:

Age Unknown  Exposure to radiation and
Gender certain chemicals
Race  Having a sibling with
Family History leukemia
Somatic mutations  HTLV-1 virus
in DNA  Genetic abnormalities
 Chromosomal translocation
Active
encogene/deactivate
tumor-suppressor gene
Malignant
transformation of
lymphoid stem cell
s/sx:
Uncontrolled proliferation of the Treatment:
Bone pain
lymphoblast in the bone marrow Analgesic
Joint pain
Diagnostic Test: Lymphoblasts replace Treatment:

BM aspiration the normal marrow  Remission induction
BM biopsy elements Therapy
 Consolidation and
maintenance therapy
 BM transplantation
 CNS prophylaxis
Decreased production of
normal blood cells
PRIORITIZED NURSING PROBLEM FOR LEUKEMIA
Nursing Diagnosis Nursing Intervention Rationale
Risk for Infection Independent
1. Place the patient in a private  To protect the patient from

room. Limit visitors as potential sources of
indicated. Require good pathogens or infection. Bone
hand washing protocol for marrow suppression,
all personnel and visitors. neutropenia, and
chemotherapy place the
patient at high risk for
infection.
2. Require good hand washing
protocol for all personnel  Prevents cross-contamination
and visitors. and reduces risk of infection.
3. Closely monitor  Although fever may

temperature. Note accompany some forms of
correlation between chemotherapy, progressive
temperature elevations and hyperthermia occurs in some
chemotherapy treatments. types of infections, and fever
Observe for fever associated (unrelated to drugs or blood
with tachycardia, products) occurs in most
hypotension, and subtle leukemia patients.
mental changes. Septicemia may occur
without fever.
4. Prevent chilling. Force  Helps reduce fever, which

fluids, administer tepid contributes to fluid
sponge bath. imbalance, discomfort, and
CNS complications.
5. Encourage frequent turning  Prevents stasis of respiratory

and deep breathing. secretions, reducing risk of
atelectasis or pneumonia.
6. Auscultate breath sounds,  Early intervention is

noting crackles, rhonchi. essential to prevent sepsis in
Inspect secretions for immuno-suppressed people.
changes in characteristics:
increased sputum
production or change in
sputum color.
7. Handle patients gently.  Prevents sheet burn and skin
Keep linens dry and excoriation.
wrinkle-free.
8. Inspect skin for tender,  May indicate local infection.

erythematous areas; open Open wounds may not
wounds. Cleanse skin with produce pus because of
antibacterial solutions. insufficient number of
granulocytes.
9. Inspect oral mucous  The oral cavity is an

membranes. Provide good excellent medium for growth
oral hygiene. Use a soft of organisms and is
toothbrush, sponge, or susceptible to ulceration and
swabs for frequent mouth bleeding.
care.
 Additional measures to avoid
10. Provide thorough skin care infection.
by keeping the patient’s
skin and perianal area clean;
apply mild lotion or creams
to keep the skin from drying
or cracking. Thoroughly
clean skin before all
invasive skin procedures.
Dependent
1. Administer medications as ● May be given

indicated: prophylactically or to
a. antibiotics treat specific infection.
● Restores WBCs
b. colony-stimulating destroyed by
factors: chemotherapy and
sargramostim reduces risk of severe
(Leukine) infection and death in
certain types of leukemia.
● Aspirin can cause gastric

c. Avoid use of aspirin- bleeding and further
containing decrease platelet count.
antipyretics
● Conserves energy for

Interdependent healing, cellular
regeneration.
1. Prepare for and assist with
leukemia-specific
treatments such as
chemotherapy, radiation,
and/or bone marrow
transplant.
Reference:
https://nurseslabs.com/5-
leukemia-nursing-care-plans/

Leukemia PATHOPHYSIOLOGY

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LEUKEMIA

Predisposing factors: ETIOLOGY: Precipitating factors:

Diagnostic Test: Lymphoblasts replace Treatment:

Risk for Infection Independent

1. Place the patient in a private  To protect the patient from

3. Closely monitor  Although fever may

4. Prevent chilling. Force  Helps reduce fever, which

5. Encourage frequent turning  Prevents stasis of respiratory

6. Auscultate breath sounds,  Early intervention is

8. Inspect skin for tender,  May indicate local infection.

9. Inspect oral mucous  The oral cavity is an

1. Administer medications as ● May be given

● Aspirin can cause gastric

● Conserves energy for

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