- History: Describe onset as acute to vague (insidious) with few
symptoms. - Cold that does not resolve completely.
- Pallor, fatigue, listlessness, irritability, fever, and anorexia may be
noted. - May mimic symptoms of rheumatoid arthritis symptoms or
mononucleosis. - Regular physical can reveal lab values indicating disease.
The result of this crowding depends on the cells that are compromised, as
shown in Table 8-1.
Test Results
Peripheral blood smear used for initial diagnosis—immature leukocytes
noted (See Table 8-2).
Bone marrow aspiration or biopsy used for definitive diagnosis—
hypercellularwith blast cells dominating.
Lumbar puncture done after diagnosis to determine CNS involvement
(rarely noted).
Chest CT scan and bone scans to detect metastasis to lung.Treatments
Chemotherapy is performed with or without cranial irradiation in four
phases:3(^156) Pediatric Nursing Demystified
Cell Type Compromise Resulting Impact Residual Effects
Red blood cells (RBCs) Low production Decreased oxygen Shortness of breath
(anemia) transport with exertion
Activity intolerance
Pallor
Platelets Decreased production Decreased clotting Bleeding tendency
White blood cells (WBCs) Decreased functional Decreased immune Susceptibility to
WBCs function. infection
Immature leukocytes Excessive production Crowding within bone Pain in bone
of nonfunctional cells and pressure and joints
Thinning of bone Pathologic fractures
shaft and weakening
TABLE 8–1•Impact of Leukemia on Blood Cells