Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)

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Outline

Pathophysiology

Lymphoma refers to cancer of the lymphatic system. This system includes the lymph nodes (glands located throughout the body), spleen, thymus gland and bone marrow. There are two main types of lymphoma: Hodgkin’s and Non-Hodgkin’s lymphoma, and they are classified as such depending on the type of cell involved.  Treatment depends on the type and severity. Lymphoma is characterized by painless, swollen lymph nodes.

Etiology

Lymphoma begins when a disease-fighting white blood cell (lymphocyte) develops a genetic mutation. Doctors are still unclear as to what causes this change, but have found that the mutation causes the cells to multiply rapidly and go on living when normal cells would die. The accumulation of these diseased lymphocytes causes swelling of the lymph nodes.  Certain risk factors increase the chance of developing lymphoma, including being male, over 55, having an impaired immune system or taking immunosuppressants, and certain infections such as Epstein-Barr virus and Helicobacter pylori.

Desired Outcome

Maintain adequate ventilation, prevent infection, manage pain and symptoms of side effects related to treatments

Lymphoma (Hodgkin’s, Non-Hodgkin’s) Nursing Care Plan

Subjective Data:

  • Persistent Fatigue
  • Shortness of breath
  • Cough
  • Itching
  • Night sweats
  • Lack of appetite

Objective Data:

  • Swollen, painless lymph glands / nodes
  • Fever, without infection
  • Weight loss

*Symptoms are not always present*

Nursing Interventions and Rationales

  • Monitor respiratory status and provide supplemental oxygen as necessary.

 

If lymph nodes of the neck and chest are involved, patient may experience shortness of breath, dyspnea and airway obstruction due to obstruction of the trachea or superior vena cava.

 

  • Note changes to the skin color; pallor or cyanosis

 

As th

Writing a Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)

A Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s) starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.

e WBCs multiply rapidly, it can reduce the oxygen carrying capacity of the red blood cells, resulting in hypoxemia.

 

  • Observe for neck vein distention, headache, dizziness, facial edema, dyspnea and stridor

 

Lymphoma patients are at higher risk for vena cava syndrome in which the  superior vena cava is obstructed from enlarged lymph nodes. This constitutes a life-threatening emergency and MD should be notified. Emergency radiation treatment may be ordered.

 

  • Assess and manage pain; teach relaxation techniques, administer analgesics as necessary

 

While the enlarged lymph nodes are usually painless, patients may experience pain with radiation or chemotherapy treatments. Management of pain and reduction of stress is essential to patients to promote healing and conserve energy.

 

  • Nutrition education; monitor daily weight and caloric intake; encourage patients to eat small frequent meals and increase protein intake.

 

Patients may experience lack of appetite and diminished nutrition. Increasing caloric intake promotes healing, provides fuel for energy and prevents gastric distention. Offer more palatable options frequently.

 

  • Provide supportive comfort measures following radiation or chemotherapy treatments.

 

Patients often experience extreme fatigue, nausea and vomiting following treatment. Assist with ADLs, offer ice chips and antiemetics as appropriate for nausea.

 

  • Assist with positioning and monitor for skin breakdown

 

Fatigue and impaired nutrition cause muscle weakness. Assist patients to positions of comfort for optimal air exchange and monitor skin for signs of breakdown due to prolonged bed rest.

Writing a Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s)

A Nursing Care Plan (NCP) for Lymphoma (Hodgkin’s, Non-Hodgkin’s) starts when at patient admission and documents all activities and changes in the patient’s condition. The goal of an NCP is to create a treatment plan that is specific to the patient. They should be anchored in evidence-based practices and accurately record existing data and identify potential needs or risks.


References

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Transcript

Hey guys, let’s talk about the care plan for lymphoma. In this lesson, we’ll briefly take a look at the pathophysiology and etiology of lymphoma, also subjective and objective data included in the care plan, as well as nursing interventions and rationales. 

 

So lymphoma is defined as cancer of the lymphatic system including the lymph nodes, spleen, thymus gland, and bone marrow. There are two types of lymphoma: Hodgkin’s and non-Hodgkin’s lymphoma. They are classified as such, depending on the type of cell involved.  Treatment depends on the type and the severity of lymphoma is characterized by painless, swollen lymph nodes. 

 

Lymphoma begins when a disease-fighting white blood cell or lymphocyte develops a genetic mutation. Doctors are unclear of what causes this change, but have found that the mutation causes the cells to multiply rapidly and continue to live when a normal cell would die. The accumulation of the diseased lymphocytes causes the swelling of the lymph nodes. Certain risk factors increase the chance of developing lymphoma, including being male over the age of 55, having an impaired immune system, and certain infections like Epstein BARR virus, as well as H pylori. 

 

The desired outcome is to maintain adequate ventilation, prevent infection and manage pain and symptoms of the side effects related to treatments. Let’s take a look at some of the subjective and objective data that your patient with lymphoma may present with. Now, remember subjective data are going to be things that are based on your patient’s opinions or feelings, and with lymphoma, your patient may complain of persistent fatigue, shortness of breath, cough, itching, night sweats, and lack of appetite. 

 

Objective or measurable data includes swollen, painless lymph glands or nodes, fever without infection and weight loss. Keep in mind that lymphoma symptoms are not always going to be present. 

 

Nursing interventions are a super important part of a care plan, so let’s take a look at those next. First, monitor your patient’s respiratory status. If lymph nodes of the neck and chest are involved, the patient may experience shortness of breath, dyspnea, an airway obstruction due to obstruction of the trachea, or the superior vena cava. Note changes in your patient’s skin color, including pallor or cyanosis. As the white blood cells multiply rapidly, it can reduce the carrying capacity of the red blood cells resulting in hypoxemia. Lymphoma patients are at a higher risk for vena cava syndrome in which the superior vena cava is obstructed from enlarged lymph nodes. So, observe for neck vein distension, headache, dizziness, facial edema, dyspnea, and stridor.This constitutes a life threatening emergency and the provider should be notified immediately. Emergency radiation treatment may be ordered for this issue. 

 

While enlarged lymph nodes are usually painless, patients may experience pain with radiation and chemotherapy treatments, so management of pain and reduction of stress is essential to patients to promote healing and conserve their energy. Teach relaxation techniques and administer analgesics as necessary. Patients with lymphoma may experience a lack of appetite and diminished nutrition, so increasing caloric intake promotes healing, provides fuel for energy, and prevents gastric distension. Encourage patients to eat small/ frequent meals and increase their protein intake. Monitor your patient’s daily weight as well as their caloric intake. Be sure to provide supportive comfort measures to your patient following chemo or radiation treatment, as patients oftentimes, experience fatigue as well as nausea and vomiting following these treatments. Assist with their ADL’s, offer ice chips and anti-emetics as appropriate for nausea. Finally, fatigue and impaired nutrition cause muscle weakness. Assist patients to positions of comfort for optimal air exchange and monitor skin for signs of breakdown due to this prolonged bed rest. 

 

Here is a look at the completed care plan for lymphoma. We love you guys. Now, go out and be your best self today and as always, happy nursing!

 

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