Thursday, 8 December 2011


Non-Hodgkin's lymphoma

Non-Hodgkin's lymphoma is cancer of the lymphoid tissue, which includes the lymph nodes, spleen, and other organs of the immune system.


White blood cells called lymphocytes are found in lymph tissues. They help prevent infections. Most lymphomas start in a type of white blood cells called B lymphocytes, or B cells.
For most patients, the cause of this cancer is unknown. However, lymphomas may develop in people with weakened immune systems. For example, the risk of lymphoma increases after an organ transplant or in people with HIV infection.

There are many different types of non-Hodgkin's lymphoma. It is classified according to how fast the cancer spreads.
  • The cancer may be low grade (slow growing), intermediate grade, or high grade (fast growing). Burkitt's tumor is an example of a high-grade lymphoma. Follicular lymphoma is a low-grade lymphoma
  • The cancer is further sub-classified by how the cells look under the microscope, for example, if there are certain proteins or genetic markers present.
According to the American Cancer Society, a person has a 1 in 50 chance of developing non-Hodgkin's lymphoma. Most of the time, this cancer affects adults. However, children can get some forms of lymphoma. High-risk groups include those who have received an organ transplant or who have a weakened immune system.
This type of cancer is slightly more common in men than in women.

Signs and symptoms of NHL include the following:
  • Swollen, painless lymph nodes in the neck, armpits, or groin
  • Unexplained weight loss
  • Fever
  • Night sweats
  • Coughing, trouble breathing, or chest pain
  • Weakness and tiredness that don't go away (fatigue)
  • Abdominal pain or swelling, or a feeling of fullness in the abdomen
  • Itching of the skin

Treatment depends on:
  • The type of lymphoma
  • The stage of the cancer when you are first diagnosed
  • Your age and overall health
  • Symptoms, including weight loss, fever, and night sweats
  • Radiation therapy may be used for disease that is confined to one body area.

Chemotherapy is the main type of treatment. Most often,multiple different drugs are used in combination together.

Another drug, called rituximab (Rituxan), is often used to treat B-cell non-Hodgkin's lymphoma.

Radioimmunotherapy may be used in some cases. This involves linking a radioactive substance to an antibody that targets the cancerous cells and injecting the substance into the body.

People with lymphoma that returns after treatment or does not respond to treatment may receive high-dose chemotherapy followed by an autologous bone marrow transplant (using stem cells from yourself).

Additional treatments depend on other symptoms. They may include:
  • Transfusion of blood products, such as platelets or red blood cells
  • Antibiotics to fight infection, especially if a fever occurs

Nursing Care Plan for Non-Hodgkin's Lymphoma

Priority Nursing
  • Providing physical and psychological support for diagnostic tests and treatment programs.
  • Preventing complications
  • Eliminate pain
  • Provides information about the disease / prognosis and treatment needs

  • Complications prevented / decreased
  • Receive real situation.
  • Pain relief / control
  • The disease process / prognosis, possible complications and treatment programs understand.

Nursing Diagnosis Nursing Care Plan for Non-Hodgkin's Lymphoma 
  • Ineffective Breathing Pattern
  • Ineffective Airway Clearance

Risk factors include
Tracheobronchial obstruction, mediastinal node enlargement or edema and airway path (Hodgkin's and non-Hodgkin's), superior vena cava syndrome (non-Hodgkin's)

Possible evidenced by
(not applicable, the existence of signs and symptoms make the actual diagnosis)

Expected Result / Patient Evaluation Criteria will
Maintaining Normal Breathing Pattern / Effective Free Dyspnea, cyanosis or Signs Other Respiratory distress

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