1
Yanick Nobrun Jean, MS
Capscare Academy for Health Care Education
Medical Surgical Nursing 1
Chapter 34, Management of Patients With Hematologic Neoplasms
Nursing Care Plan
Multiple Myeloma
Prof. CarolAnn Marchand
June 3, 2019
NURSING
, 2
Chapter 34, Management of Patients With Hematologic Neoplasms
John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple
myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is
scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and
should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The
patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for
zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen,
and Vicodin.
Medical Diagnosis: Multiple myeloma
Definition of medical diagnosis: Multiple myeloma is a cancer that arises from a type of white
blood cell called a plasma cell. Plasma cells originate in the bone marrow and play an important
role in the immune system.
Multiple myeloma develops when a normal plasma cell changes into a myeloma cell. These are
cancerous cells that can multiply uncontrollably. A normal plasma cell becomes cancerous
because of changes in the bone marrow or changes in a cell’s DNA (genetic mutations).
People with multiple myeloma develop tumors in more than one location in the bone marrow and
sometimes outside the bone marrow. That is why the disease is called multiple myeloma.
Multiple myeloma is more common in men than women, and more common in African
Americans than in those of other backgrounds. The median age at the time of diagnosis is 63
years old
In multiple myeloma, the malignant plasma cells produce an increased amount of a specific
immunoglobulin that is nonfunctional, (Liesveld, J. L., & Lichtman, M. A. (2010).
Common signs/ symptoms:
, 3
Bone pain or fractures, including compression fractures of the spine, which can cause
severe pain, particularly in the back backache that lasts for months, which can signal that
multiple myeloma is affecting the bones in the spine or the ribs Frequent infections, especially
bacterial infections of the respiratory or urinary tracts, which occur because the immune
system is weakened. Fatigue, weight loss, or general discomfort caused by anemia (insufficient
red blood cells) Nausea, vomiting, an altered mental state, depression, or headaches, caused by
an abnormally high calcium level in the blood (hypercalcemia). Changes to the kidneys that
cause fatigue, a buildup of fluid in the lower limbs, nausea, or vomiting. Bruising, rashes,
nosebleeds, vision loss, headaches, dizziness, or numbness, tingling, or a burning pain in the
hands or feet (peripheral neuropathy), caused by blood that has thickened due to a high level
of proteins. Shooting pain in the arms or legs caused by a tumor in the spinal column pressing
on nerves, (Liesveld, J. L., & Lichtman, M. A. (2010).
3. Potential complications:
Hypercalcemia
Dehydration
Constipation
Altered mental status,
Confusion, and perhaps coma
Infection
Bone loss
Anemia
Yanick Nobrun Jean, MS
Capscare Academy for Health Care Education
Medical Surgical Nursing 1
Chapter 34, Management of Patients With Hematologic Neoplasms
Nursing Care Plan
Multiple Myeloma
Prof. CarolAnn Marchand
June 3, 2019
NURSING
, 2
Chapter 34, Management of Patients With Hematologic Neoplasms
John King, 60 years of age, is a male patient who is admitted with the diagnosis of multiple
myeloma. He presents with a spinal fracture of the fifth lumbar vertebrae. The patient is
scheduled for a vertebroplasty of the spinal fracture. The patient is to remain on bed rest and
should be log rolled. Osteolytic lesions are seen in x-rays of the skull, vertebrae, and ribs. The
patient has hypercalcemia. The patient’s uric acid level is elevated. The patient has orders for
zoledronic acid (Zometa), thalidomide (Thalomid), allopurinol (Zyloprim), calcitonin, ibuprofen,
and Vicodin.
Medical Diagnosis: Multiple myeloma
Definition of medical diagnosis: Multiple myeloma is a cancer that arises from a type of white
blood cell called a plasma cell. Plasma cells originate in the bone marrow and play an important
role in the immune system.
Multiple myeloma develops when a normal plasma cell changes into a myeloma cell. These are
cancerous cells that can multiply uncontrollably. A normal plasma cell becomes cancerous
because of changes in the bone marrow or changes in a cell’s DNA (genetic mutations).
People with multiple myeloma develop tumors in more than one location in the bone marrow and
sometimes outside the bone marrow. That is why the disease is called multiple myeloma.
Multiple myeloma is more common in men than women, and more common in African
Americans than in those of other backgrounds. The median age at the time of diagnosis is 63
years old
In multiple myeloma, the malignant plasma cells produce an increased amount of a specific
immunoglobulin that is nonfunctional, (Liesveld, J. L., & Lichtman, M. A. (2010).
Common signs/ symptoms:
, 3
Bone pain or fractures, including compression fractures of the spine, which can cause
severe pain, particularly in the back backache that lasts for months, which can signal that
multiple myeloma is affecting the bones in the spine or the ribs Frequent infections, especially
bacterial infections of the respiratory or urinary tracts, which occur because the immune
system is weakened. Fatigue, weight loss, or general discomfort caused by anemia (insufficient
red blood cells) Nausea, vomiting, an altered mental state, depression, or headaches, caused by
an abnormally high calcium level in the blood (hypercalcemia). Changes to the kidneys that
cause fatigue, a buildup of fluid in the lower limbs, nausea, or vomiting. Bruising, rashes,
nosebleeds, vision loss, headaches, dizziness, or numbness, tingling, or a burning pain in the
hands or feet (peripheral neuropathy), caused by blood that has thickened due to a high level
of proteins. Shooting pain in the arms or legs caused by a tumor in the spinal column pressing
on nerves, (Liesveld, J. L., & Lichtman, M. A. (2010).
3. Potential complications:
Hypercalcemia
Dehydration
Constipation
Altered mental status,
Confusion, and perhaps coma
Infection
Bone loss
Anemia
