Marie with acute lymphocytic leukemia suffers from nausea and headache. These clinical manifestations may indicate all of the following except:
A. Effects of radiation
B. Chemotherapy side effects
C. Meningeal irritation
D. Gastric distension
Correct Answer: D. Gastric distension
Acute Lymphocytic Leukemia (ALL) does not cause gastric distention. It does invade the central nervous system, and clients experience headaches and vomiting from meningeal irritation. The primary care provider and nurse practitioner may be responsible for follow up after treatment and report back to the interprofessional team. These patients need close monitoring as they are prone to infections, coagulation dyscrasias, and relapse.
Option A: Some effects of radiation are nauseas, vomiting, and headaches. The pharmacist should educate the patient on chemotherapy medications, their adverse effects, and benefits. The dietitian should encourage a healthy diet. To prevent infections, the nurse practitioner should encourage hand washing, washing of fruits and vegetables and maintaining good personal hygiene.
Option B: Chemotherapy side effects include nausea, vomiting, and hair loss. Treatment options include prochlorperazine, haloperidol, metoclopramide, lorazepam, dexamethasone, ondansetron, granisetron, dolasetron, palonosetron, dronabinol, aprepitant, fosaprepitant, netupitant. palonosetron has a longer half-life, better efficacy, and higher binding affinity than granisetron.
Option C: Clients may experience headaches and vomiting due to meningeal irritation. Meningitis can have a varied clinical presentation depending on age and immune status of the host. Symptoms typically include fever, neck pain/stiffness, and photophobia. More non-specific symptoms include headache, dizziness, confusion, delirium, irritability, and nausea/vomiting.