Leukemia is a malignant proliferation of white blood cell precursors in bone marrow or lymph tissue and their accumulation in peripheral blood, bone marrow, and body tissues. The blood’s cellular components originate primarily in the marrow of bones such as the sternum, iliac crest, and cranium. All blood cells begin as immature cells (blasts or stem cells) that differentiate and mature into RBCs, platelets, and various types of WBCs. In leukemia, many immature or ineffective WBCs crowd out the developing normal cells. As the normal cells are replaced by leukemic cells, anemia, neutropenia, and thrombocytopenia occur.
Nursing Care Plans
The care plan for patients with leukemia should be emphasized on comfort, minimize the adverse effects of chemotherapy, promote preservation of veins, manage complications, and provide teaching and psychological support.
- Risk for Infection
- Risk for Deficient Fluid Volume
- Acute Pain
- Activity Intolerance
- Deficient Knowledge
- Other Possible Nursing Care Plans
May be related to
- Physical agents, e.g., enlarged organs/lymph nodes, bone marrow packed with leukemic cells
- Chemical agents, e.g., antileukemic treatments
- Psychological manifestations, e.g., anxiety, fear
Possibly evidenced by
- Reports of pain (bone, nerve, headaches, and so forth)
- Guarding/distraction behaviors, facial grimacing, alteration in muscle tone
- Autonomic responses
- Report pain is relieved/controlled.
- Appear relaxed and able to sleep/rest appropriately.
- Demonstrate behaviors to manage pain.
|Investigate reports of pain. Note changes in degree (use scale of 0–10) and site.||Helpful in assessing need for intervention; may indicate developing complications.|
|Monitor vital signs, note nonverbal cues, e.g., muscle tension, restlessness.||May be useful in evaluating verbal comments and effectiveness of interventions.|
|Provide quiet environment and reduce stressful stimuli. Limit or reduce noise, lighting, constant interruptions.||Promotes rest and enhances coping abilities.|
|Place in position of comfort and support joints, extremities with pillows or padding.||May decrease associated bone or joint discomfort.|
|Reposition periodically and assist with gentle ROM exercises.||Improves tissue circulation and joint mobility.|
|Provide comfort measures (massage, cool packs) and psychological support, encouragement, or presence.||Minimizes need for or enhances effects of medication.|
|Review patient’s own comfort measures.||Successful management of pain requires patient involvement. Use of effective techniques provides positive reinforcement, promotes sense of control, and prepares patient for interventions to be used after discharge.|
|Evaluate and support patient’s coping mechanisms.||Using own learned perceptions or behaviors to manage pain can help patient cope more effectively.|
|Encourage use of stress management techniques. Teach relaxation and deep-breathing exercises, guided imagery, visualization.||Facilitates relaxation, augments pharmacological therapy, and enhances coping abilities.|
|Assist with and provide diversional activities, relaxation techniques.||Helps with pain management by redirecting attention.|
|Monitor uric acid level as appropriate.||Rapid turnover and destruction of leukemic cells during chemotherapy can elevate uric acid, causing swollen painful joints in some patients. Massive infiltration of WBCs into joints can also result in intense pain.|
|Administer medications as indicated:|
||Given for mild pain not relieved by comfort measures. Avoid aspirin-containing products because they may potentiate hemorrhage.|
||Used around-the-clock, rather than prn, when pain is severe. Use of patient-controlled analgesia (PCA) is beneficial in preventing peaks and valleys associated with intermittent drug administration and increases patient’s sense of control.|
||May be given to enhance the action of analgesics or opioids.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other care plans for hematologic and lymphatic system disorders:
- Anaphylactic Shock | 4 Care Plans
- Anemia | 4 Care Plans
- Aortic Aneurysm | 4 Care Plans
- Deep Vein Thrombosis | 5 Care Plans
- Disseminated Intravascular Coagulation | 4 Care Plans
- Hemophilia | 5 Care Plans
- Leukemia | 5 Care Plans
- Lymphoma | 3 Care Plans
- Sepsis and Septicemia | 6 Care Plans
- Sickle Cell Anemia Crisis | 6 Care Plans