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Which lymph nodes are the most common sites of Hodgkin's Lymphoma's initial development?
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Cervical, axillary or inguinal lymph nodes. A mediastinal mass is the second most common area.
T/F The lymphadenopathy associated with Hodgkins lymphoma is typically freely moveable, painless and nontender.
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True
A patient with Hodgkin's lymphoma may experience weight loss, fatigue, weakness, fever, chills, tachycardia or night sweats. They may also experience itching, coughing, dyspnea, stridor, dysphagia or pain after drinking alcohol. Of this list, what are the B symptoms that denote a worse prognosis for the patient? (3)
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Weight loss, fever and night sweats (grouped together)
Which form of lymphoma (Hodgkin's or non-Hodgkin's)can involve B or T lymphocytes?
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Non-Hodgkins
What are the symptoms associated with mediastinal involvement in Hodgkin's Lymphoma?
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Cough, dyspnea, stridor, dysphagia from the increased pressure from lymph node enlargement on surrounding structures.
What is the definitive diagnostic test for Hodgkin's Lymphoma?
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Excisional lymph node biopsies, they are used to detect the presence of Reed-Sternberg cells
What diagnostic tool is the most important for staging Hodgkin's Lymphoma?
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A bone marrow aspiration/biopsy
Hodgkin's lymphoma is typically treated with varying durations of the ABVD chemotherapy protocol. What drugs are included in this regimen?
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A-Adriamycin B-Bleomycin V-Vinblastine D-Dacarbazine
Patients in the advanced stages of Hodgkin's Lymphoma may be treated with the ABVD protocol and the MOPP protocol, alternating between the two. What drugs are included in the MOPP regimen?
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M-Mechlorethamine O-Oncovin (vincristine) P-Procarbazine P-Prednisone
What are the common complications experienced by patients who have achieved remission of Hodgkin's lymphoma?
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Secondary malignancies, endocrine, cardiac and/or pulmonary dysfunctions. Often these develop many, many years later
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What are the three most common secondary malignancies experienced by patients who have had Hodgkin's lymphoma?
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Acute myelogenous leukemia (AML), non-Hodgkin’s lymphoma, and solid tumors.
Which patient has a better prognosis, the one with Hodgkin's Lymphoma or the one with Non-Hodgkin's Lymphoma?
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The one with Hodgkin's. NHL has a poor prognosis due to its insidious, diffuse nature
Who is most likely to experience remission, the patient with an indolent form of Non-Hodgkin's Lymphoma or the person with an aggressive form of Non-Hodgkin's Lymphoma?
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The person with the more aggressive form. It is more difficult to cause remission in a patient with the indolent form
Who is at most risk for developing multiple myeloma?
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An African American, male, over age 40
What is the most common presenting symptoms of multiple myeloma?
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Skeletal pain, namely in the ribs, pelvis or spine that is triggered by movement
What are the proteins that are screened for in a patient with suspected multiple myeloma?
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M proteins/myeloma proteins. They are produced by the malignant cells.
How is the prognosis for multiple myeloma determined?
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B2 microglobulins and albumin are measured. The higher the B2 or the lower the albumin, the worse the prognosis.
What is the underlying cause of most of the problems associated with multiple myeloma?
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Hypercalcemia. It can cause renal and heart damage, seizures, coma, etc. The hypercalcemia is caused by the destruction of bone by the malignant cells.
What are the major nursing considerations for a patient with multiple myeloma?
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Keep them hydrated to minimize problems with hypercalcemia. Urinary output should be between 1.5-2 L a day. This may require an intake of 3-4 L. Encourage weight bearing exercises. Corticosteroids may help excrete excess calcium. Electrolytes need to be monitored closely as well as kidney function. Hypercalcemia can cause kidney problems and the treatments can cause hyperuricemia which can also damage the kidneys (allopurinol is prescribed to help prevent this). In addition, the high pr
What do most patients with multiple myeloma die from?
Show Answer
Bacterial infections, you must monitor them closely for s/s of infection
  
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