Lymphoma refers to cancer of the lymphatic system. This system includes the lymph nodes (glands located throughout the body), spleen, thymus gland and bone marrow. There are two main types of lymphoma: Hodgkin’s and Non-Hodgkin’s lymphoma, and they are classified as such depending on the type of cell involved. Treatment depends on the type and severity. Lymphoma is characterized by painless, swollen lymph nodes.
Lymphoma begins when a disease-fighting white blood cell (lymphocyte) develops a genetic mutation. Doctors are still unclear as to what causes this change, but have found that the mutation causes the cells to multiply rapidly and go on living when normal cells would die. The accumulation of these diseased lymphocytes causes swelling of the lymph nodes. Certain risk factors increase the chance of developing lymphoma, including being male, over 55, having an impaired immune system or taking immunosuppressants, and certain infections such as Epstein-Barr virus and Helicobacter pylori.
Maintain adequate ventilation, prevent infection, manage pain and symptoms of side effects related to treatments
*Symptoms are not always present*
If lymph nodes of the neck and chest are involved, patient may experience shortness of breath, dyspnea and airway obstruction due to obstruction of the trachea or superior vena cava.
As the WBCs multiply rapidly, it can reduce the oxygen carrying capacity of the red blood cells, resulting in hypoxemia.
Lymphoma patients are at higher risk for vena cava syndrome in which the superior vena cava is obstructed from enlarged lymph nodes. This constitutes a life-threatening emergency and MD should be notified. Emergency radiation treatment may be ordered.
While the enlarged lymph nodes are usually painless, patients may experience pain with radiation or chemotherapy treatments. Management of pain and reduction of stress is essential to patients to promote healing and conserve energy.
Patients may experience lack of appetite and diminished nutrition. Increasing caloric intake promotes healing, provides fuel for energy and prevents gastric distention. Offer more palatable options frequently.
Patients often experience extreme fatigue, nausea and vomiting following treatment. Assist with ADLs, offer ice chips and antiemetics as appropriate for nausea.
Fatigue and impaired nutrition cause muscle weakness. Assist patients to positions of comfort for optimal air exchange and monitor skin for signs of breakdown due to prolonged bed rest.
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