NUR 231 Final Exam Questions And Answers 100%
Solved
Where does hematopoietic malignancy originate?
The hematopoietic stem cell, the myeloid, or the lymphoid stem cell
What are lymphomas?
Neoplasms of lymphoid tissue
When do clonal stem cell disorders occur?
When the control mechanism fail, and "indolent" clone may evolve to more aggressive clone cells.
What is hematopoiesis?
Rapid, continuous turnover of blood cells
What is the patho of leukemia?
Is a neoplastic proliferation of one particular cell type granulocytes, monocytes [i.e. precursor to
macrophages], lymphocytes [type of WBC or leukocyte involved in immune function].
Cancer of WBC
What are lymphomas neoplasms of?
Lymphoid tissues, usually derived from B lymphocytes
What is multiple myeloma?
A malignancy of the most mature form of B lymphocyte - the plasma cell in the bone marrow with
destruction of bone
Cells Of The Immune System
Hematopoiesis
What is leukocytosis?
Refers to an increased level of leukocytes (WBCS) in the circulation.
How many cells are increased in leukocytosis?
Only one specific cell
When should the elevation of leukocytes normally decrease?
When the physiologic need decreases
What does a prolonged or progressively increasing elevation in leukocytes mean?
,Abnormal, should be evaluated
What is a persistent leukocytosis?
Hematologic malignancy
What is the cause of leukemia?
-Not fully known, but there is some evidence of genetic and viral influences.
-Bone marrow damage from radiation exposure or from chemicals can cause leukemia
What is leukemia?
Hematopoietic malignancy with unregulated proliferation of leukocytes
What are the types of leukemia?
-Lymphoid (ALL, CLL)
•Stem cells that produce lymphocytes
-Myeloid (AML, CML)
•Stem cells that produce non-lymphoid blood cells
-Acute (few weeks)
-Chronic (months to years)
•Generally better treated.
Can chronic leukemia transform into acute?
Yes, at any point
Cells of the immune system - lymphocytic, acute/chronic myeloid leukemia, mutliple myeloma.
Where does leukemia start?
In the bone marrow before the cells are born
Where do lymphomas start?
When lymphoid cells move out of bone marrow and are still trying to mature and grow
What is acute myeloid leukemia a defect of?
Defect in stem cell that differentiate into all myeloid cells: monocytes, granulocytes, erythrocytes, and
platelets
What is the most common non-lymphocytic leukemia?
Acute Myleoid Leukemia (AML)
Who does acute myeloid leukemia affect?
All ages with peak incidence at age 60 years old
Is the prognosis of AML variable?
Yes, highly variable.
,What are the granulocytes affected in AML?
Neutrophils, basophils, eosinophils
What is a significant factor of AML?
Age! Pt who are younger may survive for 5 years or more after diagnosis
What is the 5 year survival rate for patients with AML who are 50 or younger?
43%
What is the 5 year survival rate for pt with AML who are between 50-64?
19%
What is the 5 year survival rate for pts with AML who are older than 75?
1.6%
How quickly do the sxs of AML develop?
Over weeks, without warning
What do the AML sxs result from?
Insufficient production of normal blood cells
What are the clinical manifestations of AML?
-Neutropenia (causing fever and infection)
-Thrombocytopenia (causing weakness, fatigue, and bleeding tendencies)
-Hyperplasia of the gums
-Petechiae
-Ecchymosis
-Leukemic infiltrates
-Lymphadenopathy
-Splenomegaly (rare)
What are leukemic infiltrates?
Infiltration of leukemic cells in skin or extensor surface of forearms
What is lymphadenopathy?
Enlargement of the lymphnodes
, What are the additional sxs of AML when there is proliferation of leukemic cells within organs?
-Pain from enlarged liver or spleen
-Hyperplasia of the gums
-Bone pain from expansion of arrow
What is the CBC like in AML?
Decrease in both erythrocytes and platelets.
The total leukocyte count may be low, normal, or high, but the percentage of normal cells is vastly
decreased
May have a white blood cell count of 0.
What is the bone marrow analysis like in AML?
-Immature blast cells (leukocytes)
-More than 20% blasts which is the hall mark diagnosis!!
What is the normal % of blasts in the bone marrow?
5% and under is normal
What is important to do as a nurse with a patient during bone marrow aspiration?
Support patients emotionally and physically through procedures
What is the procedure like for a bone marrow aspiration and biopsy?
•Informed consent required
•Side lying or prone position
•Local anesthetic or mild sedative for anxiety
•Acute pain with aspiration of marrow content
What is the management post-procedure of a bone marrow aspiration and biopsy?
•Pressure dressing with sterile occlusive covering
•Bedrest 30-60 minutes
-Lay on pressure site.
•Apply ice and avoid blood thinning analgesics
What is the goal of AML treatment?
Complete remission - having a bone marrow biopsy less than 5% is complete.
What is the treatment of AML?
-Aggressive chemo
-Induction therapy (hospitalization for several weeks)
What is the nursing management of AML?
-Administering blood products (PRBS and platelets)
-Promptly treating infections
Solved
Where does hematopoietic malignancy originate?
The hematopoietic stem cell, the myeloid, or the lymphoid stem cell
What are lymphomas?
Neoplasms of lymphoid tissue
When do clonal stem cell disorders occur?
When the control mechanism fail, and "indolent" clone may evolve to more aggressive clone cells.
What is hematopoiesis?
Rapid, continuous turnover of blood cells
What is the patho of leukemia?
Is a neoplastic proliferation of one particular cell type granulocytes, monocytes [i.e. precursor to
macrophages], lymphocytes [type of WBC or leukocyte involved in immune function].
Cancer of WBC
What are lymphomas neoplasms of?
Lymphoid tissues, usually derived from B lymphocytes
What is multiple myeloma?
A malignancy of the most mature form of B lymphocyte - the plasma cell in the bone marrow with
destruction of bone
Cells Of The Immune System
Hematopoiesis
What is leukocytosis?
Refers to an increased level of leukocytes (WBCS) in the circulation.
How many cells are increased in leukocytosis?
Only one specific cell
When should the elevation of leukocytes normally decrease?
When the physiologic need decreases
What does a prolonged or progressively increasing elevation in leukocytes mean?
,Abnormal, should be evaluated
What is a persistent leukocytosis?
Hematologic malignancy
What is the cause of leukemia?
-Not fully known, but there is some evidence of genetic and viral influences.
-Bone marrow damage from radiation exposure or from chemicals can cause leukemia
What is leukemia?
Hematopoietic malignancy with unregulated proliferation of leukocytes
What are the types of leukemia?
-Lymphoid (ALL, CLL)
•Stem cells that produce lymphocytes
-Myeloid (AML, CML)
•Stem cells that produce non-lymphoid blood cells
-Acute (few weeks)
-Chronic (months to years)
•Generally better treated.
Can chronic leukemia transform into acute?
Yes, at any point
Cells of the immune system - lymphocytic, acute/chronic myeloid leukemia, mutliple myeloma.
Where does leukemia start?
In the bone marrow before the cells are born
Where do lymphomas start?
When lymphoid cells move out of bone marrow and are still trying to mature and grow
What is acute myeloid leukemia a defect of?
Defect in stem cell that differentiate into all myeloid cells: monocytes, granulocytes, erythrocytes, and
platelets
What is the most common non-lymphocytic leukemia?
Acute Myleoid Leukemia (AML)
Who does acute myeloid leukemia affect?
All ages with peak incidence at age 60 years old
Is the prognosis of AML variable?
Yes, highly variable.
,What are the granulocytes affected in AML?
Neutrophils, basophils, eosinophils
What is a significant factor of AML?
Age! Pt who are younger may survive for 5 years or more after diagnosis
What is the 5 year survival rate for patients with AML who are 50 or younger?
43%
What is the 5 year survival rate for pt with AML who are between 50-64?
19%
What is the 5 year survival rate for pts with AML who are older than 75?
1.6%
How quickly do the sxs of AML develop?
Over weeks, without warning
What do the AML sxs result from?
Insufficient production of normal blood cells
What are the clinical manifestations of AML?
-Neutropenia (causing fever and infection)
-Thrombocytopenia (causing weakness, fatigue, and bleeding tendencies)
-Hyperplasia of the gums
-Petechiae
-Ecchymosis
-Leukemic infiltrates
-Lymphadenopathy
-Splenomegaly (rare)
What are leukemic infiltrates?
Infiltration of leukemic cells in skin or extensor surface of forearms
What is lymphadenopathy?
Enlargement of the lymphnodes
, What are the additional sxs of AML when there is proliferation of leukemic cells within organs?
-Pain from enlarged liver or spleen
-Hyperplasia of the gums
-Bone pain from expansion of arrow
What is the CBC like in AML?
Decrease in both erythrocytes and platelets.
The total leukocyte count may be low, normal, or high, but the percentage of normal cells is vastly
decreased
May have a white blood cell count of 0.
What is the bone marrow analysis like in AML?
-Immature blast cells (leukocytes)
-More than 20% blasts which is the hall mark diagnosis!!
What is the normal % of blasts in the bone marrow?
5% and under is normal
What is important to do as a nurse with a patient during bone marrow aspiration?
Support patients emotionally and physically through procedures
What is the procedure like for a bone marrow aspiration and biopsy?
•Informed consent required
•Side lying or prone position
•Local anesthetic or mild sedative for anxiety
•Acute pain with aspiration of marrow content
What is the management post-procedure of a bone marrow aspiration and biopsy?
•Pressure dressing with sterile occlusive covering
•Bedrest 30-60 minutes
-Lay on pressure site.
•Apply ice and avoid blood thinning analgesics
What is the goal of AML treatment?
Complete remission - having a bone marrow biopsy less than 5% is complete.
What is the treatment of AML?
-Aggressive chemo
-Induction therapy (hospitalization for several weeks)
What is the nursing management of AML?
-Administering blood products (PRBS and platelets)
-Promptly treating infections
