Objectives & Key Points
What is lymphedema?
Accumulation of lymphatic fluid from impaired lymph circulation.
A client develops swelling after lymph-node removal during a mastectomy. What condition is most likely?
Secondary lymphedema.
What malignant cell is diagnostic of Hodgkin disease?
Reed–Sternberg cell.
Which blood test is listed among the diagnostic studies for Hodgkin disease?
CBC
For lymphedema, what simple positioning intervention is listed?
Elevate the affected extremity.
What are the two types of lymphedema named in the chapter?
Primary (congenital) and secondary.
Name three characteristic skin findings associated with lymphedema.
Tight, firm, shiny, brawny skin; weeping or oozing may also occur.
What viral association and cellular change are described for Hodgkin disease?
Epstein-Barr virus is described as mutating some lymphocytes, creating Reed–Sternberg cells.
Name two imaging studies listed for Hodgkin disease.
CT and MRI; and chest radiography .
Name two nursing interventions for lymphedema.
Skin assessment and exercises; elevation, elastic compression garments, mechanical devices, and emotional support are also listed.
What is lymphoma?
A group of cancers that affect the lymphatic system.
What medical management is listed for lymphedema?
Elevation, compression sleeve/stocking, and complex decongestive physiotherapy including massage.
Name four signs/symptoms of Hodgkin disease from the chapter.
Examples: painless lymph-node enlargement, weight loss, fatigue/weakness, low-grade fever, pruritus, night sweats, anorexia, anemia, thrombocytopenia, poor resistance to infection.
What procedure is listed to examine lymphatic vessels?
Lymphangiography
For lymphangitis/lymphadenitis, name three nursing interventions.
Assist with ADLs, elevate the extremity, provide warmth, and monitor temperature and swelling.
Name the two lymphoma types emphasized in this chapter.
Hodgkin disease and non-Hodgkin lymphoma.
Lymphangitis and lymphadenitis are associated in the chapter with what microorganisms?
Streptococcal microorganisms.
How are non-Hodgkin lymphomas classified in the chapter?
Indolent or aggressive
What bone-marrow procedure is listed in the diagnostic workup for Hodgkin disease?
Bone marrow aspiration/biopsy
A client with Hodgkin disease is at risk for ineffective airway clearance and impaired gas exchange. What interventions are listed?
Assess respiratory status, administer oxygen, and prepare for intubation.
Name at least four nursing problems identified for clients with Hodgkin disease/non-Hodgkin lymphoma.
Examples: ineffective airway clearance, impaired gas exchange, infection, and impaired skin integrity.
A client has red streaks, fever, and tender enlarged lymph nodes. What condition fits, and what medical treatment is listed?
Lymphangitis/lymphadenitis; broad-spectrum antibiotic therapy.
Name four treatment approaches listed for non-Hodgkin lymphoma.
Radiation, chemotherapy, immunotherapy, monoclonal antibody therapy, bone marrow transplant, or stem-cell transplant.
What staging range is listed for Hodgkin disease?
Stages I through IV
A client receiving chemotherapy/radiation for non-Hodgkin lymphoma is being taught supportive care. What fluid-related teaching is listed?
Encourage extra fluid intake.