Lymphoma Case Study
Setting: Outpatient clinic
Index Words: Hodgkin's disease, cancers, assessment, radiation therapy, diagnostic assessments, symptom management
A. T. is known as a 21-year-old college student. He performs part-time as being a manual worker, uses half a can of smokeless cigarette each week, and drinks a six-pack of beer within the weekend. A year ago in Sept. 2010, he discovered a small, painless lump in the lower still left neck. Above the quarter, he experienced raising fatigue and a 10-pound weight loss that he related to " functioning and studying too hard. вЂќ In the early spring he did find a nurse practitioner with the student wellness center who also immediately referenced him to the oncologist. A lymph client biopsy exposed Hodgkin's disease. The gallium scan, cuboid scan, and CT check of the upper body, abdomen, and pelvis every came back negative. A workplace set ups laparotomy was conducted monthly later to confirm the diagnosis. His analysis was Hodgkin's disease, level IA, blended cellularity. You are a personnel nurse inside the outpatient oncology services if a. T. will come in.
1 . A. T. wants to know what Hodgkin's disease can be and how this individual " caughtвЂќ it. And what will you tell him?
We would tell him that it can be cancer of the lymphocytes, which leads to an enhancement of the lymph nodes. A patient will usually have a inflammed lymph client and its generally painless. To diagnose Hodgkin's Lymphoma, there should be a biopsy. It is the occurrence of Reed-Sterngerg cells that differentiate that from non-Hodgkin's. It is binucleated or multi-nucleated in a backdrop of inflammatory cells. You will find no suggestions for stopping Hodgkin's lymphoma; the cause is unknown or perhaps multifactorial.
Several risk factors for Hodgkin's Lymphoma contain:
* Sex: male
* Ages: 15-40 and over fifty-five
* Family history and ancestors
5. History of contagious mononucleosis or infection with Epstein-Barr disease, a causative agent of mono 2. Weakened immune system, including contamination with HIV or the existence of HELPS * Long term use of human growth hormone
2 . A. T. would like to know what " stage IAвЂќ means; he also would like to know the relevance of the check results. Exactly what you going to tell him?
I might tell him that Stage IA means that this individual has one particular lymph node involved upon 1 side of the diaphragm or one particular extra crucial (outside the lymph node) organ/tissue. The A means this individual has no weight loss, drenching night sweats, or perhaps fevers. I might also simply tell him that this individual has a great prognosis plus the cancer is far more localized and easier to take care of.
A number of days later you see A. T. in the oncologist's office during his appointment to go over the treatment regimen for radiotherapy. His prescribed radiation treatment regimen (outpatient)
includes Wednesday through Fri with treatments scheduled for approximately 6 to 10 several weeks. Admission analysis findings on his first trip to the outpatient oncology medical center at the end of January happen to be weight 193 pounds, height 78 ins. Vital signs (VS) 124/66, 60, 16, 98. 0п‚°пЂ F (oral). Heart: heart rate frequent. Respiratory: obvious to prospection. Neuromuscular/skeletal, GI, and genitourinary (GU): bad. Integumentary/oral: cut from workplace set ups laparotomy very well approximated without erythema, edema, pain, or perhaps drainage. Cut from lymph node dissection healing well, oral mucosa pink and moist, not any palpable adenopathy.
3. What abnormal evaluation findings do you recognize in the last information?
His systolic BP is definitely slightly elevated. Continue to screen his weight loss.
5. A. T. jokes along that your dog is " likely to get nuked and shine. вЂќ What information might you include in the teaching to prepare him for radiation remedies?
First off I might explain to him that this individual only can have the " nuked and glowвЂќ with internal the radiation. With the Exterior radiation that he is obtaining, he is certainly not radioactive and will interact with others around him. I would also include:
1 ) You want to protect the markings.
2 . Usually do not use lotions, soaps or deodorants.
a few. Avoid...
Sources: American Malignancy Society
Nationwide Cancer Company
Medical-Surgical Nursing: Essential Thinking in Patient Attention, 5th model. Priscilla LeMone, Karen Burkie, and Gerene Bauldoff