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
- 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
- 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.
|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 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