Medical-surgical Nursing Demystified

(^190) Medical-Surgical Nursing Demystified
a longer course. The chronic patients typically have an insidious onset and a bet-
ter prognosis.
HALLMARK SIGNS AND SYMPTOMS

• Acute patients:
  
  
  • Fatigue and weakness due to anemia
  
  
  • Fever due to increased susceptibility to infection
  
  
  • Bleeding, petechiae, ecchymosis (bruising), epistaxis (nosebleed), gingival
    (gum) bleeding—due to decreased platelet count
  
  
  • Bone pain due to bone infiltration and marrow expansion
  
  
  • Lymph nodes (lymphadenopathy) enlarged as leukemic cells invade nodes
  
  
  • Liver (hepatomegaly) and spleen (splenomegaly) enlarged as leukemic cells
    invade
  
  
  • Headache, nausea, vomiting, and weight loss
  
  
  • Papilledema, cranial nerve palsies, seizure if there is central nervous sys-
    tem involvement
  
  
  
  


• Chronic patients:
  
  
  • Fatigue due to anemia
  
  
  • Weight loss due to chronic disease process and loss of appetite
  
  
  • Poor appetite
  
  
  • Enlarged lymph nodes (lymphadenopathy) due to infiltration of lymph nodes
  
  
  • Enlarged spleen (splenomegaly) due to involvement of the spleen
  
  
  
  

INTERPRETING TEST RESULTS

• Low RBC count, low hemoglobin—anemia.


• Low platelet count—thrombocytopenia.


• Elevated WBC count—leukocytosis.


• Abnormal amount of immature WBC shown in bone marrow biopsy.

TREATMENT

• Acute myelogenous leukemia.
  
  
  • Administer an anthracycline (idarubicin or daunorubicin) plus cytarabine.