الاثنين، 27 أغسطس 2018

201-Non-Hodgkin Lymphoma

About
A malignancy that involves all lymphoid tissue and potentially several lymph nodes. Majority has malignant B lymphocytes. Occurs more frequently with advancing age.
Assess
Lymphadenopathy; fever, chills, weight loss, night sweats. Masses pushing on other organs causing additional symptoms.
Complications
Infection, respiratory compromise, metastasis, location related complications ( abdominal mass- abd pain, upper chest mass- airway obstruction, etc), second malignancies, death
Diagnosis
  • Knowledge deficit related to disease process and management
  • Ineffective coping related to concerns and fears regarding diagnosis and treatment.
  • Anticipatory grieving related to diagnosis and treatment.
  • Risk for infection related to immune system dysfunction and compromise.
Goals
  • The client will identify treatment options for disease.
  • The client will verbalize concerns and fears related to diagnosis and treatment options.
  • The client will identify factors that can increase the likelihood of additional malignancy.
  • The client will identify signs and symptoms of infection.
  • The client will identify methods to decrease the risk of infection.
Interventions
  • Assess vitals, CBC with differential, pain level and location, presence of other masses,  knowledge about disease and treatment options.
  • Prepare client for additional diagnostics to rule out other malignancies.
  • Encourage coughing and deep breathing exercises and incentive spirometry to prevent respiratory infections.
  • Administer chemotherapy and prepare for radiation therapy as indicated by physician.
  • Provide opportunities for client to verbalize concerns, feelings, and fears related to diagnosis and treatment.
  • Teach client signs and symptoms of infection or complications to report immediately to health care provider.
  • Teach client methods to prevent infection including hand-washing, avoiding large crowds, monitoring temperature.
  • Teach client factors that can increase the likelihood of additional malignancies ( smoking, excessive sun, alcohol, carcinogens).
  • Teach client potential complications related to therapy ( additional malignancy, infertility, infections, immune dysfunction, fatigue).
  • Monitor for complication of treatment ( chemo, radiation therapy).

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