Lymphomas are a group of cancers in which cells of the lymphatic system become abnormal and start to grow uncontrollably. Because there is lymph tissue in many parts of the body, lymphomas can start in almost any organ of the body.
Primary malignant lymphoma: The excessive proliferation of lymphocytes which forms part of the immune system. Primary cancers refer to the fact that the cancer originated in the lymph cells rather than having metastasized. More detailed information about the symptoms, causes, and treatments of Primary malignant lymphoma is available below.
Nursing Assessment for Malignant Lymphoma
Assessment at the client's malignant lymphoma by Doenges, (1999) obtained the following data:
1. Activity / rest
- Symptoms: fatigue, weakness, or general malaise, loss of productivity and decreased exercise tolerance.
- Signs: decreased strength, shoulders slumped, walking slowly, and other signs that show fatigue.
- Symptoms: palpitations, angina / chest pain.
- Signs: tachycardia, dysrhythmias, cyanosis face and neck (venous drainage obstruction due to enlarged lymph nodes is a rare occurrence), scleral jaundice, and general jaundice, liver damage and in connection with bile duct obstruction by enlarged lymph nodes, pallor (anemia), diaphoresis , night sweats.
3. Ego integrity
- Symptoms: stress factor, fear / anxiety in connection with the diagnosis and possible fear of death, diagnostic tests and treatment modalities (chemotherapy and radiation therapy).
- Signs: various behaviors, such as angry, withdrawn, passive.
4. Elimination
- Symptoms: changes in urine and stool characteristics, history of intussusception obstruction, or malabsorption syndrome (infiltration of retro-peritoneal lymph nodes)
- Signs: tenderness in the right upper quadrant on palpation and enlargement (hepatomegaly), tenderness in the left upper quadrant on palpation and enlargement (splenomegaly), decreased urine output, dark urine, anuria (urethral obstruction / fail ginja), bowel dysfunction, and bladder.
5. Food / fluid
- Symptoms: anorexia / loss of appetite, dysphagia (esophageal pressure) weight loss.
- Signs: swelling of the face, neck, jaw, or right hand (secondary to superior vena cava compensated by enlarged lymph nodes), lower extremity edema in relation to the inferior vena cava obstruction of intra-abdominal lymph node enlargement (non-Hodgkin), ascites (obstruction in vena cava inferior with respect to intra-abdominal lymph node enlargement)
6. Neurosensory
- Symptoms: nerve pain (neuralgia) indicates nerve root compression by enlarged lymph nodes in the brachial, lumbar, and sacral plexus, muscle weakness, paresthesias.
- Signs: mental status; lethargy, withdrawal, lack of interest in the general vicinity, paraplegia (spinal stem compression from vertebral tubauh, discus involvement in compression / degeneration or compression of the blood supply to the spinal rod)
7. Pain / comfort
- Symptoms: tenderness / pain on the affected lymph nodes, eg at about mediastinum, chest pain, back pain (vertebral compression) general bone pain (bone involvement limfomatus), pain in the affected area immediately after drinking alcohol.
- Mark: a focus on self, cautious behavior.
8. Breathing
- Symptoms: dyspnea at work or rest; chest pain
- Symptoms: dyspnea; tachycardia, dry non-productive cough, respiratory distress signal; increased respiratory rate and depth, use of accessory muscles, stridor, cyanosis, husky / laryngeal paralysis (pressure of enlarged nodes in laryngeal nerve).
9. Security
- Symptoms: a history of frequent / infection, mononukleus history, history of ulcer / perforation gastric bleeding, fever, night sweats without chills, redness / general pruritus
- Symptoms: fever settled without any symptoms of infection, lymph node symmetric, no pain, swollen / enlarged, enlarged tonsils, general pruritus, most areas of melanin pigmentation loss (vitilago).
Once the data is collected, followed by analysis of the data to determine nursing diagnoses.
According Doenges (1999), nursing diagnoses in clients with postoperative laparotomy + biopsy, with an indication of malignant lymphomas as follows:
- Risk for Infection related to invasive procedures, the surgical incision.
- Risk for Fluid Volume Deficit related to excessive loss, ie: vomiting, bleeding, diarrhea.
- Acute Pain related to the surgical incision.
- Activity Intolerance related to general weakness, decreased energy reserves, increase the metabolic rate of the production of massive leukocytes.
- Constipation or Diarrhea related to decreased dietary input, change the digestive process.
- Risk for Impaired Skin Integrity related to decreased blood and nutrients to the tissues, secondary surgery.
- Knowledge Deficit related to lack of accurate information about home care.
