Nursing 211

N211: Health Differences Across the Lifespan I Non-Hodgkin’s disease is the most common form of lymphoma; it is more common in men than in women. There is no known cause, but there is a link to viral infections, immune disorders, genetic abnormalities, exposure to chemicals, and infections with Helicobacter pylori. Often involves malignant B cells, usually originates outside the lymph nodes. Normal cells are crowded out by malignant cells in affected lymphoid tissue. Nursing Assessment with Hodgkin’s disease a firm, painless enlargement of one or more lymph nodes on one side of the neck; fatigue and weakness, anorexia and dysphagia, pruritus and jaundice, severe but brief pain at the site after the ingestion of alcohol, abdominal pain and bone pain. Enlarged lymph nodes, liver and spleen. Also seen is fever without chills and night sweats. Nursing Assessment with Non-Hodgkin’s disease is painless lymph node involvement, abdominal pain, nausea, vomiting, hematuria, peripheral neuropathy, headaches, visual disturbances, and change in mental status and seizures. Nursing Diagnosis • Anxiety and knowledge deficit related to diagnosis of cancer and treatments • Risk for infection related to myelosuppression from treatment • Pain related to diagnostic procedures and progression of the disease • Fatigue related to effects to treatment • Altered nutrition: less than body requirements related to anorexia secondary to effects of disease process and treatments • Impaired tissue integrity related to high dose chemotherapy and radiation therapy Medical Interventions for Hodgkin’s disease include radiation therapy; chemotherapy with Nitrogen Mustard (Mustargen), vincristine (Oncovin), procarbazine and prednisone (MOPP) or ABVD, Doxorubicin (Adriamycin), bleomycin (Blenoxane), vinblastine (Velban) and dacarbazine. Autologenous or allogenic bone marrow transplant is also an option. Medical Interventions for Non-Hodgkin’s disease is palliative radiation therapy; chemotherapy with CHOP, Cyclophosphamide (Cytoxan), doxorubicin (Adriamycin), vincristine (Oncovin) and prednisone. Chemotherapy with BACOP, Bleomycin (Blenoxane), doxorubicin (Adriamycin), cyclophosphamide (Cytoxan), vincristine (Oncovin), prednisone. Autologenous or allogenic bone marrow transplant is also an option. Nursing Interventions include protect client from infection, monitor temperature carefully; observe for signs of anemia, provide adequate rest, encourage high nutrient food and provide emotional support to client and family. Teach male clients that chemotherapy will render them sterile and they may wish to bank sperm prior to treatment. Assist in balancing activity with periods of rest. Provide and maintain a good nutritional state. Help client to cope with bodily changes such as alopecia, weight loss and sterility.


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