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Definition
Hodgkins disease is a lymphoma
Lymphomas are malignant disorders of
the reticuloendothelial system that results
in an accumulation of dysfunctional,
immature lymphoid-derived cells
It originates in the lymphoid system and
involves predominantly lymph nodes
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FOUR STAGES
Stage I
Hodgkin's disease is found in only 1 lymph
node area, or has extended locally into
adjacent tissue (IE).
Stage II
Hodgkin's disease is found in 2 or more
lymph node areas on the same side of the
diaphragm (muscle beneath the lungs that
moves up and down to help you breathe).
The cancer extends locally from the lymph
node(s) to adjacent tissue (IIE).
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Stage III
Either of the following means that the disease is a
Stage III:
Hodgkin's disease is found in lymph node areas
on both sides of the diaphragm.
The cancer may also have extended to an area
or organ adjacent to the lymph node and/or to the
spleen (IIIE/IIISE).
Stage IV
Hodgkin's disease has spread to 1 or more
organs outside the lymphatic system such as the
bone marrow or liver.
Progressive or Recurrent Hodgkin's Disease:
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Clinical Manifestations
Common symptoms include:
Painless enlargement of lymph nodes
(generally unilateral)
Fever and chills
Night sweats
Weight loss
Pruritus
Various symptoms may occur with
pulmonary involvement, superior vena
cava obstruction, hepatic or bone
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Diagnostic Evaluation
Tests are used to determine extent of
disease involvement before treatment
and followed at regular intervals to
assess response to treatment
CBC: determines abnormal cells
Lymph node biopsy: determines type of
lymphoma
Bilateral bone marrow aspirate and
biopsy: determine whether bone marrow
is involved
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Medical Management
Choice of treatment depends on extent of
disease, histopathologic findings, and
prognostic indicators
Hodgkins disease is more readily cured
than other lymphomas
5-year survival: 80%
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Radiation Therapy
Treatment of choice for localized disease
Areas of body where lymph node chains
are located can generally tolerate high
radiation doses
High-energy rays are used (or particles) to
destroy cancer cells or slow their rate of
growth.
Vital organs are protected with lead
shielding during radiation treatment
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Chemotherapy
Chemotherapy is systemic therapy, which
means the drug enters the bloodstream
and circulates throughout the body to reach
and destroy cancer cells.
Is the use of drugs for killing cancer cells.
The drugs can be taken by mouth in pill or
liquid form, or they can be injected into a
vein under the skin or in a muscle.
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Complications
Side effects of radiation:
Acute side effects: during treatment to 6
months after treatment
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Nursing Management
Nursing Diagnosis
Impaired Skin Integrity related to high-dose
radiation therapy
Altered Oral Mucous Membranes related to
high-dose ration therapy
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Nursing Interventions
Maintaining Tissue Integrity
Avoid rubbing, powders, deodorants,
lotions, or ointments (unless prescribed) or
application of heat/cold to treated area
Encourage client to keep treated area
clean and dry, bathing gently with tepid
water and mild soap
Encourage wearing loose-fitting clothes
Advise the client to protect skin from
exposure to sun, chlorine, temperature
extremes
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Daghang Salamat
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