A patient recently been diagnosed with leukemia. Which of the following symptoms would a nurse expect to see… - GMCH Chandigarh - 2019

GMCH Chandigarh - 2019

Medical Surgical Nursing

Easy

Appeared in: GMCH Chandigarh - 2019

Explanation

Leukemia is a cancer of the bone marrow that leads to the uncontrolled production of abnormal white blood cells.
These abnormal cells crowd out the production of normal blood cells, leading to pancytopenia: anemia (low red blood cells), thrombocytopenia (low platelets), and neutropenia (low normal white blood cells).
Anemia causes fatigue, thrombocytopenia causes easy bruising and bleeding, and the infiltration of leukemic cells into the bone marrow causes significant bone pain.
This triad of symptoms—fatigue, bruising, and bone pain—is a classic clinical presentation of leukemia resulting directly from bone marrow failure.

Option B: This set of symptoms points more towards a primary cardiovascular issue. While palpitations can be associated with anemia, bradycardia is not a typical sign of leukemia (tachycardia is more common). Hypotension is a late-stage complication, not a primary symptom.
Option C: This is a non-specific combination of symptoms that does not align with the classic presentation of leukemia. While abdominal pain can occur due to organ enlargement, it is not typically grouped with paresthesia and a facial rash as primary indicators.
Option D: Although dyspnea and malaise are common in leukemia due to anemia, hypotension is not a hallmark presenting symptom. Its presence would suggest a serious complication like sepsis or hemorrhage, rather than the underlying disease process itself.

Clinical Relevance

Nursing practice connection: Use the key finding related to Clinical manifestations of Leukemia to guide bedside assessment, documentation, and the next nursing action.
A nurse's primary role in caring for a patient with leukemia involves vigilant monitoring for signs of infection and bleeding, which are the most immediate life-threatening risks.
Key nursing interventions include implementing bleeding precautions (e.g., using a soft toothbrush, avoiding IM injections) and neutropenic precautions (e.g., strict hand hygiene, protective isolation if the absolute neutrophil count is low).
Patient education on recognizing and reporting fever, new bruising, or bleeding is crucial for early intervention and management of complications.

How to Approach the Question

First, identify the core concept of the question, which is to recognize the classic symptoms of leukemia.
Recall the basic pathophysiology of leukemia: it is a cancer of the bone marrow, the factory for blood cells.
Consider the function of the bone marrow: it produces red blood cells (for oxygen), white blood cells (for immunity), and platelets (for clotting).
Logically deduce the effects of bone marrow failure. When cancerous cells take over, the production of all normal cells decreases.
Evaluate each option based on this understanding: a lack of RBCs causes fatigue; a lack of platelets causes bruising; and the infiltration of the marrow itself causes bone pain. This directly matches one of the options.
Eliminate the other options by identifying them as symptoms of other body systems (cardiac), non-specific symptom clusters, or signs of late-stage complications (hypotension) rather than the primary disease presentation.

Concept Tested & Keywords

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E6 Nelson Textbook of Pediatrics(2024) — Volume 2 p. 898-900