Treatment and nursing care for acute leukemia in children

Acute leukemia is treated in a hospital. Chronic leukemia can be treated on an outpatient basis. Patients are placed in sterile boxes. A strict sanitary and disinfection regime is required. Frequent change of linen. The nurse in the vestibule of the box must change the dressing gown, put on a mask, shoe covers, gloves, before entering the isolated patient. The nurse should monitor: blood pressure, respiratory rate, Ps, body weight, daily diuresis. It is necessary to monitor the patient’s oral cavity (to prevent gingivitis), prevent bedsores, carry out hygienic treatment of the skin, genital organs after physiological administration. It is necessary to take blood for analysis from a finger and a vein, to determine the blood type (for readiness for transfusion) [4].

The nurse should also provide the patient with a diet: food should be high-calorie and easily digestible, rich in vitamins B1, C and P. You should limit the intake of carbohydrates and sweets.

Acute leukemia is treated with:

Chemotherapy is the destruction of leukemic (blast) cells in the patient’s body.

Cytostatics – Vinblastine, Aminopretin, Prednisolone.

Radiation therapy – ionizing radiation.

Hormones – Prednisone, Triamcinolone, Dexamethasone.

Restorative therapy – vitamins, iron preparations, rational diet.

Comprehensive treatment prolongs the period of remission and the life of patients. In acute myeloblastic leukemias and in relapses of all acute leukemias, in some cases transplantation is performed. If there are no compatible donors, then bone marrow autotransplantation of the patient during remission is used. In case of clinical manifestations of anemia, the risk of bleeding, before the upcoming administration of cytostatics, replacement therapy, transfusion of erythrocyte mass or fresh platelet mass is carried out. With a compensated state of the patient, indications for substitution therapy should be limited [14].

Nursing diagnoses (problems with cause):

1. Physiological

· Potential problems

An increase in temperature (fever)

Pain

Gingival bleeding stomatitis

Nosebleeds

· Lack of appetite

· Weakness

Chills

2. Psychological

· To be healthy

Fear of disease

· Mental disorders

3. Social

The need for communication

Target:

Short-term: normalization of body temperature

Long-term: treatment of the underlying problem

Nursing interventions:

1. paracetamol

2. pain relief (antispasmodics)

3. tonic drink

4. ENT consultation

5. isolate the patient

6. organize a mask regimen when in contact with the patient

7. follow the regular ventilation of the premises, wet cleaning at least 2 times a day

8. The nurse should teach parents the principles of rational nutrition, taking medications as prescribed by the doctor. The patient should take:

more fresh fruits and vegetables

foods rich in vitamins C, B1 and R.

limit fats and proteins

Avoid carbohydrates and sweets

9. when organizing work and leisure, limit physical and emotional stress

10. it is necessary to teach parents and relatives how to care for the skin and mucous membranes, oral cavity, nails, hair

11. take measures to prevent injuries (explain to relatives the need to wear shoes without laces)

12. The nurse should provide psychological support to the child

13. provide emergency medical care for bleeding [15].

For nosebleeds:

seat the patient

Reassure the patient and tell him to inhale air through his nose and exhale through his mouth to speed up blood clotting

Loosen tight clothing

slightly tilt his head forward and let the blood drain

give the patient a spittoon and offer to spit out blood

apply cold to the bridge of the nose, and a heating pad to the legs

· if the bleeding has not stopped within 15 minutes, insert cotton swabs moistened with 3% hydrogen peroxide solution into the nasal passages for 10-15 minutes [3].

CONCLUSION

Having studied this material, the etiology and predisposing factors for leukemia, the clinical picture and diagnostic features, examination methods and preparation for them, the principles of treatment and prevention, manipulations performed by the nurse, we can conclude that all this will help the nurse to carry out all stages of nursing care.

The modern concept of nursing in society is to help individual children, families and groups develop their physical, mental and social potential and maintain it at an appropriate level, regardless of changing living and learning conditions.

This requires the nurse to work to promote and maintain health, as well as disease prevention.

A nurse, not only must competently perform medical appointments and carry out the nursing process, patient care, but her theoretical knowledge of a particular disease must also meet high requirements.

BIBLIOGRAPHY:

1. Matveeva I.I., Blindar V.N. Algorithm for laboratory diagnosis of acute leukemia. – Moscow, MIA, 2013. – 52 p.

2. Savchenko V.G., Parovichnikova E.N. Acute promyelocytic leukemia. – LitTerra, 2011. – 208 p.

3. Jordi V. Child health. – Labyrinth, 2012. – 300 p.

4. http://www.medmoon.ru/rebenok/deti97.html

5. http://www.eurolab.ua/encyclopedia/352/2736/

6. http://www.syl.ru/article/158443/new_simptomyi-leykoza-u-detey-analiz-krovi-pri-leykoze

7. http://medinfa.ru/article/25/117699/

8. http://www.blackpantera.ru/pediatrics/29092/

9. http://ilive.com.ua/health/leykoz-u-detey_76654i15937.html

10. http://pediatriya.info/?p=368

11. http://www.medicsolution.ru/fjbs-434-1.html

12. http://xn--d1aigtgr.xn--p1ai/?p=5947

13. http://www.amsalemmedicalcenter.org/

14. http://www.vitaminov.net/rus-27600-676661586-leucosis-6691.html

15. http://www.inmedas.ru/diseases/blood_disorders/acute_leukemia/

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