Leukemia

1. Definition of "leukemia."

1. It is the rapid production of white blood cells, many of which are immature.

2. The white blood cells, or leukocytes, may invade and damage bone marrow, lymph nodes, the spleen, the kidneys, and other organs of the body.

3. Leukemia has periods of remission, but no cure exists.

4. The disease can be acute or chronic.

2. Factors that increase the risk of leukemia.

1. Exposure to large doses of radiation.

2. Exposure to benzene and other chemicals.

3. Genetic factors.

4. Use of antineoplastic drugs.

5. Immunological deficit.

3. Signs and symptoms of leukemia.

1. Fatigue.

2. Weakness.

3. Paleness of skin.

4. Signs of bleeding:

1. Bleeding into the skin causing discoloration.

2. Nosebleeds.

3. Small, reddish-purple spots on the skin.

5. Abdominal pain or fullness.

6. Weight loss.

7. Fever.

8. Mouth sores.

9. Palpitations.

10. Nausea and vomiting.

11. Headache.

4. Measures to manage leukemia.

1. Get adequate rest to decrease anemia.

2. Prevent bleeding:

1. Report first signs of bleeding such as bruising, petechiae, bleeding gums, etc.

2. Following safety measures to avoid cuts and hemorrhage (soft toothbrush, electric razor, etc.).

3. Avoid aspirin, which may increase bleeding tendency.

3.   Prevent infection.

1. Perform meticulous hygiene.

2. Avoid large crowds and people with infections.

3. Increase fluids to decrease possibility of urinary tract infections.

4. Follow procedure of reverse isolation as needed.

5. Provide good mouth care to decrease possibility of mouth sores.

6. All care givers should wash hands thoroughly.

7. Monitor temperature for early detection of infection.

4. Obtain emotional support as needed through cancer support groups, clergy, counseling, etc.

5. Get adequate nutrition.

1. Eat small, frequent meals.

2. Eat bland, high-calorie foods. (Provide "Increased Calories" handout.)

3. Avoid nausea and loss of appetite. (Refer to "Nausea" or "Anorexia" teaching guides as needed.)

6. Provide comfort measures as needed, such as analgesics, position changes, etc.

7. Drink at least two to three quarts of fluids per day (if not contraindicated) to prevent uric acid precipitation.

5. Possible medical treatments.

1. Chemotherapy (refer to "Chemotherapy" teaching guide).

2. Radiation (refer to "Radiation" teaching guide).

6. Possible complications of leukemia.

1. Anemia.

2. Hemorrhage.

3. Infection.

4. Renal stones.