Nursing care for pediatric patients with leukemia who are receiving chemotherapy with fever due to neutropenia: Two case studies

Abstract

Nursing care for pediatric patients with leukemia who are receiving chemotherapy with fever due to neutropenia: Two case studies

Angkana T00lput

Abstract

Leukemia is a chronic disease and a public health problem. Leukemia is the most common cancer in children. Current cancer treatment methods with chemotherapy help control the spread or destroy cancer cells, which are directly related to severe side effects such as infection. Low white blood cell counts are the most severe and common complication

Results: Case study patient 1 receive chemotherapy as scheduled according to the ThaiPOG 1302/1303 protocol. History of current illness: 6 months ago, there were large lumps on both sides of the neck, not painful when pressed. Weight decreased from 36 kilograms to 24 kilograms. Blood test CBC: Blast: 11% Bone marrow biopsy found T cell ALL. Admitted to Khon Kaen Hospital. Found problems receiving chemotherapy. Fever 38 degrees Celsius, fatigue, nausea, vomiting a lot. There were small blood bruises on the arms. Low white blood cell count Case study patient 2 came to receive chemotherapy as scheduled Protocol ThaiPOG 1303. History of current illness: 7 months ago, fatigue, fatigue, shortness of breath, pale. Hct 27 Vol% Blood test CBC: Blast 46% Admitted to Khon Kaen Hospital. Found problems receiving chemotherapy. Fever 38 degrees Celsius, fatigue, nausea. Oral mucositis grade 2, ulcers all over the oral mucosa, tongue, and lips were swollen and painful, making it difficult to swallow. Eating less

Conclusion: similar major nursing problems: 1) infection due to low immunity and low white blood cell count (Febrile Neutropenia), 2) discomfort due to fever, 3) discomfort due to back pain, 4) risk of fluid imbalance due to nausea and vomiting, 5) risk of easy bleeding due to low platelets, 6) risk of oxygen deficiency due to low red blood cell count and anemia, 7) reduced activity due to fatigue and exhaustion, 8) parents and caregivers were anxious due to the child's illness. As for the different diagnoses, there was 1 nursing diagnosis: 1) risk of inadequate fluid and nutrition due to low food intake and oral mucositis. Nursing outcomes: Nursing problems were resolved and continuous care was planned. Case study 1 was discharged home with a total hospital stay of 12 days. Case study 2 was hospitalized for 20 days..

Keywords: Nursing, Leukemia, Neutropenia