Nursing Assessment for Malignant Lymphoma
Nursing Care Plan for Malignant Lymphoma
Definition of malignant lymphoma, among others according to Danielle, (1999) that lymphoma is a malignancy that arises from the lymphatic system.
Another understanding of malignant lymphoma by Susan Martin Tucker, (1998) is a group of neoplasms originating from lymphoid tissues.
Meanwhile, according to Suzanne C. Smeltzer, (2001), suggested that malignant lymphoma is a malignancy of cells derived from lymphoid cells.
Another understanding of malignant lymphoma by Doenges, (1999) is a cancer of the lymphoid glands.
Assessment on the client malignant lymphoma, according to Doenges, (1999) obtained the following data:
1. Activity / rest
Symptoms: fatigue, weakness, or general malaise, loss of the productivity and decreased exercise tolerance.
Signs: decreased strength, shoulders slumped, walking slowly, and other signs that indicate fatigue.
2. Circulation
Symptoms: palpitations, angina / chest pain.
Symptoms: tachycardia, dysrhythmias, cyanosis face and neck (venous drainage obstruction due to enlarged lymph nodes are rare events), sclera and general jaundice in connection with damage to the liver and bile duct obstruction by enlarged lymph nodes, pale (anemia), diaphoresis, night sweats day.
3. Ego integrity
Symptoms: stress factors, fear / anxiety in connection with the diagnosis and possible fear of death, diagnostic tests and treatment modalities (chemotherapy and radiation therapy).
Signs: a variety of behaviors, such as angry withdrawn, passive.
4. Elimination
Symptoms: changes in urine and stool characteristics, history of intussusception obstruction or malabsorption syndrome (infiltration of retro-peritoneal lymph nodes)
Signs: tenderness in the right upper quadrant and enlargement on palpation (hepatomegaly), tenderness in the left upper quadrant and enlargement on palpation (splenomegaly), decreased urine output, dark urine / concentrated, anuria (urethral obstruction / renal failure), bowel dysfunction and bladder.
5. Food / fluid
Symptoms: anorexia / loss of appetite, dysphagia (pressure in the esophagus) A decrease in body weight.
Signs: swelling of the face, neck, jaw, or right hand (secondary to compensate the superior vena cava by the enlarged lymph nodes), lower extremity edema in connection with the inferior vena cava obstruction of intra-abdominal lymph node enlargement (non-Hodgkin), ascites (obtruksi vein cava inferior with respect to intra-abdominal lymph node enlargement).
6. NeuroSensory
Symptoms: nerve pain (neuralgia) showed nerve root compression by enlarged lymph nodes in the brachial, lumbar, and sacral plexus, muscle weakness, paresthesias.
Signs: mental status; lethargy, withdrawal, lack of general interest to the surrounding, paraplegia (compression of the spinal rod from the vertebral body, disc involvement in compression / degeneration or compression of the blood supply to the spinal rod)
7. Pain / comfort
Symptoms: tenderness / pain in the affected lymph nodes, for example; at about mediastinum, chest pain, back pain (vertebral compression) common bone pain (bone involvement limfomatus), pain in the affected area immediately after drinking alcohol.
Signs: focus on self, cautious behavior.
8. Breathing
Symptoms: dyspnea at work or rest; chest pain
Signs: dyspnea; tachycardia, non-productive dry cough, respiratory distress signal; increase in respiratory rate and depth, use of accessory muscles, stridor, cyanosis, husky / laryngeal paralysis (pressure of enlarged nodes in laryngeal nerve).
9. Security
Symptoms: a history of frequent / infection, history of mononucleosis, a history of ulcer / perforated gastric bleeding, fever, night sweats without chills, redness / general pruritus
Symptoms: fever settled without symptoms of infection, lymph nodes symmetrical, no pain, swollen / enlarged, enlarged tonsils, general pruritus, some areas of melanin pigmentation loss (vitilago).
10. Seyuality
Symptoms: problems of fertility / pregnancy (while not affecting the disease, but the treatment affect), decreased libido.