5 Leukemia Nursing Care Plans


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.

Here are five (5) nursing care plans (NCP) and nursing diagnosis for patients with leukemia: 

  1. Risk for Infection
  2. Risk for Deficient Fluid Volume
  3. Acute Pain
  4. Activity Intolerance
  5. Deficient Knowledge
  6. Other Possible Nursing Care Plans

Activity Intolerance

Nursing Diagnosis

May be related to

  • Generalized weakness; reduced energy stores, increased metabolic rate from massive production of leukocytes
  • Imbalance between oxygen supply and demand (anemia/hypoxia)
  • Therapeutic restrictions (isolation/bedrest); effect of drug therapy

Possibly evidenced by

  • Verbal report of fatigue or weakness
  • Exertional discomfort or dyspnea
  • Abnormal HR or BP response

Desired Outcomes

  • Report a measurable increase in activity tolerance.
  • Participate in ADLs to level of ability.
  • Demonstrate a decrease in physiological signs of intolerance; e.g., pulse, respiration, and BP remain within patient’s normal range.
Nursing InterventionsRationale
Evaluate reports of fatigue, noting inability to participate in activities or ADLs.Effects of leukemia, anemia, and chemotherapy may be cumulative (especially during acute and active treatment phase), necessitating assistance.
Encourage patient to keep a diary of daily routines and energy levels, noting activities that increase fatigue.Helps patient prioritize activities and arrange them around fatigue pattern.
Provide quiet environment and uninterrupted rest periods. Encourage rest periods before meals.Restores energy needed for activity and cellular regeneration and/or tissue healing.
Implement energy-saving techniques (sitting, rather than standing, use of shower chair). Assist with ambulation and other activities as indicated.Maximizes available energy for self-care tasks.
Schedule meals around chemotherapy. Give oral hygiene before meals and administer antimetics as indicated.May enhance intake by reducing nausea.
Recommend small, nutritious, high-protein meals and snacks throughout the day.Smaller meals require less energy for digestion than larger meals. Increased intake provides fuel for energy.
Provide supplemental oxygen.Maximizes oxygen available for cellular uptake, improving tolerance of activity.

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

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See also

Other recommended site resources for this nursing care plan:

Other care plans for hematologic and lymphatic system disorders:

Matt Vera is a registered nurse with a bachelor of science in nursing since 2009 and is currently working as a full-time writer and editor for Nurseslabs. During his time as a student, he knows how frustrating it is to cram on difficult nursing topics. Finding help online is nearly impossible. His situation drove his passion for helping student nurses by creating content and lectures that are easy to digest. Knowing how valuable nurses are in delivering quality healthcare but limited in number, he wants to educate and inspire nursing students. As a nurse educator since 2010, his goal in Nurseslabs is to simplify the learning process, break down complicated topics, help motivate learners, and look for unique ways of assisting students in mastering core nursing concepts effectively.