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Presented by: Shiela Marie Vidad

Leukemia -Comes from the greak word leukus white haima means blood , is a type of cancer of the blood or bone marrow characterized by an abnormal increase of immature white blood cells called blast . -Neoplastic disorders of the blood forming tissues (spleen , lymphatic system , and the bone marrow) -it classified according to the cell line involved as either lymphocytic granulocytic or monocytic and according to the maturity or the malignant cells as either acute ( immature cells) or chronic ( differentiated cells )

CLASSIFICATIONS acute grows faster Acute lymphoblastic leukemia Chronic lymphoblastic leukemia Acute myelogenous leukemia Chronic myelogenous leukemia

*Acute - grows faster *Chronic - grows slowly but harder to treat

Acute Leukemia ( lymphocytic granulocytic or monocytic ) *ALL ( Acute Lymphocytic leukemia ) -Disease of young children and is uncommon after the age of 20 years . *AGL ( Acute Granulocytic Leukemia ) or AML ( Acute Myelocytic Leukemia ). -Affects all age groups but it is most common in adults. *Monocytic are rare leukemia

Signs and Symptoms -Weakness, fatigue , easy shortness of breath - because of immature white blood cells grows. -Loss of appetite , weight loss the feeling of fullness . -Frequent of infections/ fever immature development of WBC.WBC are the soldiers of the body. -Pain or tenderness bones or joints -Swelling of lymph nodes -Enlargement of spleen there is organ infiltration -Easily bleeding and bruising purplish patches or spots

DIAGNOSTICS TEST -Repeated CBC -Bone marrow examinations they get sample in the bone marrow by aspiration . -Lymph node biopsy they are inflammed , one source to know cancerous cells. -Blood chemistry test to test for BUN -X-ray test for some ogans that become enlarge. -MRI ( Magnetic Resonance Imaging )- test use to detect CA in the inner bones. -Ultrasound - examination use for enlargement of organs. -CT scan visualizes vertical / horizontal cross section of the body, distinguish Tumors and Cysts.

Management in Drug Toxicity *Nausea and vomiting occurs shortly after administration of several drugs and from cranial or abdominal radiation.

-Admistered antiemetic Drugs ( e.g. ordansetron [Zofran]) and combined dexamethazone as ordered
*Anorexia loss of appetite leads to weight loss.It is hard to eat for the child who is sick. -Nasogastric tube feedings or total parenteral nutrition maybe implemented for children with significant nutritional problems.

*Mucosal Ulceration one of the most distressing side effect of several drugs is GI mucosal cell damage, which can produce ulcers anywhere along the alimentary tract. -Provide bland, moist , soft diet appropriate for the childs age and preferences. -Uses a soft sponge toothbrush -Provide frequent mouth washes with normal saline or sodium bicarbornate mouth rinses. -Use local anesthetics or non prescription preparation without alcohol. *Neuropathy vinblastine can cause various neurotoxic effects. -Administering stool softness or loxatives for severe constipation caused by decreased bowel innervation. -Maintaining good body alignment -On best rest, using a foot board or high top shoes to minimize or prevent foot drop. -Safety measurements during ambulation because of weakness and numbing of the extremeties. -Provider soft or liquid diet for severe jaw pain.

Hemorrhagic Cystitis Side effect of Chemical irratation to the bladder from cyclophosphamide 1. A liberal fluid intake ( atleast oen and half times recommended daily fluid requirement ) 2. Encourage frequent voiding immediately after feeling the urge before bed, and after arising. 3. Administering the drug early in the day to allow for sufficient oral intake and voiding. 4. Administered mesna as ordered mesna ( an agent thats provide protection to the bladder)

Alopecia -hair loss is common side effect of several chemotherapeutic drugs and cranial irradiation , although not all children lose their hair during therapy *Encourage to wear soft cotton cap for childrens head wear. e.g wigs hats bonnet can be optional . Moon face -short term steroids therapy produces no acute toxicities, and produces to the beneficial reactions increase appetite and sense of well being *Provide reassurance to the child that moon face will be back to normal. Mood changes -Children experience a number of mood changes that range from feelings of well being euphoria to depression and irritability. *Encourage SO to discuss the behavioral changes to the child.