Understanding Medical Surgical Nursing Ch 25
Terms
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- lymphomas
- cancer of the lymph system
- splenectomy
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* surgical removal of the spleen
* used to treat select hematological disorders & possibly stage lymphomas - Hodgkin's disease (HD)
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* a lymphoma
* distinguishing feature is Reed-Sternberg cells
S/S: painless swelling in 1+ lymph node chains - generalized pruritus (itching) - alcohol-induced pain - fever - fatigue - weight loss - malaise - non-Hodgkin's lymphomas (NHLs)
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* includes all other type of lymphomas
* usually progresses more rapidly than HD
* arises from B cells and T cells
S/S: enlarged, painless, rubbery nodes in cervical & supraclavicular areas - enlarged tonsils & adenoids - fatigue - malaise - weight loss - overwhelming postsplenectomy infection (OPSI)
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* causitive agents include streptococci, Neisseria spp., & influenza bacteria
* 70% mortality rate
S/S: fever - malaise -
Which of the following signs is most commonly present at dx w/the lymphomas?
a. high fever
b. painful lymph nodes
c. enlarged lymph nodes
d. abdominal pain - c. enlarged lymph nodes
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Stage III Hodgkin's disease is defined as which of the following?
a. Lymphatic involvement on both sides of the diaphragm
b. Localized involvement of 2+ adjacent or nonadjacent regions on one side of the diaphragm
c. Diffuse involvement of - b. Localized involvement of 2+ adjacent or nonadjacent regions on one side of the diaphragm
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Which of the following interventions is appropriate for the pt at home who is at risk for infection?
a. Advise the pt to stay indoors
b. Encourage the pt to avoid crowds
c. Maintain strict isolation
d. Instruct the pt to avoid blood d - b. Encourage the pt to avoid crowds
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Which of the following circumstances places the pt at most risk for respiratory complications following a splenectomy?
a. Disturbance of clotting factors
b. NPO status
c. Need for frequent dressing changes
d. Location of surgical inci - d. Location of surgical incision
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Which of the following postsplenectomy symptoms should the pt report immediately?
a. Fever & malaise
b. Pain at the incision site
c. Discomfort w/coughing
d. Fatigue - a. Fever and malaise