nurse's notes

CHRONIC GRANULOCYTIC LEUKEMIA - characterized by white cell count rangin from 100,000- 1,000,000 per cu. mm. High percentage of this leukocytes are immature cells and associated with enlargement of the spleen and the liver but little swelling of the lymph nodes. Occur in the ages between 25 and 40 years old.

SIGNS AND SYMPTOMS:

• complain of the dragging sensation of the weight of the organ due to tumor of the spleen in the abdomen.
• painful and tender on pressure of long bones ( tibia, ribs, sternum)

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CHRONIC LYMPHATIC LEUKEMIA-

• characterized by by a greatky increased leukocytes count, over 90 percent of cells being mature lymphocytes.
• occur between ages 45-60 years old

SIGNS AND SYMPTOMS:

• generalyzed lymph nodes enlargement
• development of anemia, fever,cachexia
• hemorrhagic features

NURSING MANAGEMENT:

• assist the patient to accept and participate in the therapeutic regimen as effectively as possible
• control pain (sedatives as needed)
• nausea and vomitting- offer ice chips, anti-emetic drug-(per doctor's order) be given half hour before meal , small bland feeding
  
• oral fluid intake to prevent precipitation of uric acid and crystals in the kidney
• combat infection
• frequent mouth care- to remove old dried blood and combat mouth odor
• use cotton applicator instead of toothbrush to prevent gum irritation or trauma
• gentle cleaning of nostrils
• application of petroleum jelly on the lips to prevent from drying and cracking
• diet should be soft to reduce mechanical irritation of the gums
• evidence of infection ( fever-chills , skin lesions) should be promptly reported
• handle patient gently to prevent trauma
• close observation of the body orifice and skin for signs of bleeding
• place patient in bed when administering transfusion and steroids
• observed proper technique of administering blood transfusion
• demonstration of the nurse's concern for the welfare, does much to comfort the patient