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

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Included In This Lesson

Study Tools

Hodgkin’s Lymphoma Interventions (Picmonic)
Hodgkin’s Lymphoma Assessment (Picmonic)
Lymphoma Pathochart (Cheat Sheet)

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Example Nursing Diagnosis for Lymphoma (Hodgkin’s, Non-Hodgkin’s)

  1. Impaired Immunity: Lymphoma can affect the immune system. This diagnosis addresses the potential for compromised immunity.
  2. Risk for Infection: Lymphoma treatment and compromised immunity increase the risk of infections. This diagnosis emphasizes infection prevention.
  3. Anxiety: Patients with lymphoma may experience anxiety about their diagnosis and treatment. This diagnosis addresses their emotional well-being.

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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