Nursing Management: Leukemia, Neutropenia, and Pediatric Care

This report focuses on the nursing management of a 7-year-old child admitted with a history of leukemia and current neutropenia. The report begins by defining leukemia and neutropenia, emphasizing that leukemia is a cancer of the lymphatic system and bone marrow, often affecting white blood cells, while neutropenia is a condition characterized by abnormally low neutrophil counts. The signs and symptoms to be monitored include fever, swollen gums, bone pain, fatigue, shortness of breath, and signs of infection. The nursing care plan includes a comprehensive assessment, formulating nursing diagnoses (acute pain, risk of infection, and imbalanced nutrition), establishing goals (pain relief, balanced nutrition, infection prevention, and age-appropriate activity tolerance), implementing interventions (reverse barrier nursing, education on infection signs, administration of antibiotics, analgesics, and antipyretics, and nutritional support), and evaluating the patient's condition. The report highlights the importance of close monitoring, comprehensive care, and family education in managing pediatric leukemia and neutropenia. The report emphasizes the importance of a nurse assessing the patient by taking history and physical exam, drawing a plan of care, implementing the care, and evaluating the patient condition.

Running head: NURSING MANAGEMENT 1
Nursing Management
Student Name
Institutional Affiliation

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Nursing Management
Leukemia is a cancer of the lymphatic system and bone marrow. It is caused by exposure
to radiations, chemotherapy, or genetically. It usually affects the white blood cells. It occurs as a
result of abnormal gene mutations in the precursor cells leading to uncontrollable multiplication
of abnormal blood cells (Yang et al., 2016). The presence of defective leucocytes in the body
interferes with the body's ability defense against infection and later compromises the red blood
cell production. Neutropenia is a condition where the number of neutrophils in the body is less
than normal ranges. Neutrophils are the cells responsible for protecting the body against bacterial
and fungal infections. Leukemia is classified into two types; lymphocytic and myeloid. Each of
the types can occur as an acute condition or a chronic one. In young children, acute lymphocytic
leukemia is the typical type of leukemia experienced, and it accounts for 74%.
Regarding the case study, the child presents with neutropenia and a history of leukemia.
The definitive type of leukemia the child is suffering from is ALL. The signs and symptoms to
be monitored include; fever, swollen gums, bone pain, fatigue, shortness of breath, nose bleeds
and signs of infections (Vizcaino, Lopera, Martinez, Reyes, & Linares, 2016). The occurrence of
ALL prevents the formation of red blood cells which leads to anemia. Anemia presents with
fatigue and shortness of breath. Fever is a sign of infection which can occur since the body's
defense mechanism has been compromised.
Management of the patient begins with the assessment. The nurse will take a history from
the parents to gather information on signs and symptoms, and the duration the patient has
experienced them. The nurse should follow by a comprehensive physical exam, including all
systems. The nurse should then formulate a nursing diagnosis based on the patient presentation.

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The priority nursing diagnosis include; Acute pain related to inflammation and tissue infiltration
by lymphocytes, infection risk related to the compromised immune system, imbalanced nutrition
less than body requirement related to increased body metabolism (Bernard, Abdelsamad,
Johnson, Chapman, and Parvathaneni, 2017). The nurse should establish priority goals towards
patient needs; ensure relieve from pain, attain balanced nutrition, minimize chances of infection,
and enable the baby to tolerate activity regarding the age. The nurse should apply reverse barrier
nursing and educate the family on the signs and symptoms of detecting infection before
complications. The nurse should also administer prescribed prophylactic antibiotics, analgesics,
and antipyretics while recording the patient's temperature hourly. The nurse should educate the
family on nutrition by providing foods rich in calories and protein. The nurse should evaluate the
patient condition after the intervention to assess the need for a change of interventions.
In conclusion, leukemia is cancer that affects the marrow of the bone and majorly defects
white blood cells. The acute types of leukemia occur rapidly, while chronic types take a long
time to be symptomatic. The symptoms arise from the compromised bone marrow function and
can cause anemia, decreased platelets, and fall in the number of healthy white blood cells.
Children who have leukemia require close monitoring of symptoms. In the management, the
nurse has to assess the patient by taking history and physical exam, draw a plan of care,
implement the care, and evaluate the patient condition.

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References
Bernard, S.C., Abdelsamad, E.H., Johnson, P.A., Chapman, D.L. and Parvathaneni, M., 2017.
Pediatric Leukemia: Diagnosis to Treatment–A Review. Journal of Cancer Clinical
Trials, 2(2), 1. doi
10.1016/j.clml.2018.07.250.https://www.springer.com/medicine/oncology/journal/432.
Vizcaino, M.P., Lopera, J., Martinez, L., Reyes, I. and Linares, A., 2016. Clinical Practice
Guidelines for Early Detection, Diagnosis, Treatment, and Monitoring of Acute
Lymphocytic Leukemia in Children and Teenagers in a Developing Country. Pediatric
Infect Dis, 1(25), pp.2573-0282. doi 10.21767/2573-0282.100024.
https://www.mayoclinic.org/diseases-conditions/acute-lymphocytic-leukemia/symptoms-
causes/syc-20369077
Yang, L., Rodriguez, B., Mayle, A., Park, H.J., Lin, X., Luo, M., Jeong, M., Curry, C.V., Kim,
S.B., Ruau, D. and Zhang, X., 2016. DNMT3A loss drives enhancer hypomethylation in
FLT3-ITD-associated leukemias. Cancer cell, 29(6), pp.922-934. doi
10.1016/j.ccell.2016.07.015. https://mdanderson.elsevierpure.com/en/perso/ns/ju-seog-
lee/publications.