Nursing Care Plan for Lymphoma (Hodgkin’s, Non-Hodgkin’s)
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.
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.
Maintain adequate ventilation, prevent infection, manage pain and symptoms of side effects related to treatments
Lymphoma (Hodgkin’s, Non-Hodgkin’s) Nursing Care Plan
- Persistent Fatigue
- Shortness of breath
- Night sweats
- Lack of appetite
- 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 the 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.
Cornell Note-Taking System Instructions:
- Record: During the lecture, use the note-taking column to record the lecture using telegraphic sentences.
- Questions: As soon after class as possible, formulate questions based onthe notes in the right-hand column. Writing questions helps to clarifymeanings, reveal relationships, establish continuity, and strengthenmemory. Also, the writing of questions sets up a perfect stage for exam-studying later.
- Recite: Cover the note-taking column with a sheet of paper. Then, looking at the questions or cue-words in the question and cue column only, say aloud, in your own words, the answers to the questions, facts, or ideas indicated by the cue-words.
- Reflect: Reflect on the material by asking yourself questions, for example: “What’s the significance of these facts? What principle are they based on? How can I apply them? How do they fit in with what I already know? What’s beyond them?
- Review: Spend at least ten minutes every week reviewing all your previous notes. If you do, you’ll retain a great deal for current use, as well as, for the exam.
For more information, visit www.nursing.com/cornell