A Case Study Acute Lymphocytic Leukemia

University of Baguio

General Luna Road, Baguio City

School Nursing

Baguio General Hospital and Medical Center

A Case Study Presented to the

Faculty of School of Nursing

In Partial Fulfilment

Of the Requirements for the Subject

Maternal and Child Nursing

By:

NBA – Group 1

Allaga, Charmaine Ann

Bernardo, Maria Cristina
Boleyley, Angelo Gabriel
Dumlao, Charmane Sherisse Mariano
Jungbauer, Sabina
Molina, Jan Kelvin
Olabode, Victor
Palbusa, Frizzel Denver
Ramos, Edythe Alexis
 INTRODUCTION

A. BRIEF INTRODUCTION

We, section NBA group 1 were assigned at Baguio general Hospital and

Medical Center; in Pediatric ward; 3pm-11pm shift, last ____________

under the supervision of Mr. Elton John Delos Santos

During our duty in the Pediatric ward, our group was exposed and

experienced caring different cases such Cancer, hirshprungs disease,

hypertension and etc. Among these cases, our group chose to study

Acute Lymphoblastic leukemia because we want to know more about this

case, the different etiologic factors that may contribute to the

development of the disease.

Acute lymphoblastic leukemia (ALL) is the most common malignancy

diagnosed in children, representing more than a quarter of all

pediatric cancers. It is a malignant (clonal) disease of the bone

marrow in which early lymphoid precursors proliferate and replace the

normal hematopoietic cells of the marrow. ALL may be distinguished

from other malignant lymphoid disorders by the immunophenotype of the

cells, which is similar to B- or T-precursor cells. Immunochemistry,

cytochemistry, and cytogenetic markers may also aid in categorizing

the malignant lymphoid clone.

There are 3,500 cancer cases in children younger than 15 each

year in the Philippines, and around half of them are ALL, a cancer

that affects the blood and bone marrow, according to the Manila-based

NGO Cancer Warriors Foundation, Inc. (CWFI). Nationwide, eight of

every 10 children with paediatric cancer died in 2008 (a total of

2,800 deaths). “The first obstacle to saving more children from ALL in

the Philippines was the prices of drugs - among the highest in Asia,”

said Carmen Vallejo Auste, co-founder of CWFI.

In acute lymphoblastic leukemia (ALL), a lymphoid progenitor cell

becomes genetically altered and subsequently undergoes dysregulated

proliferation, with clonal expansion. In ALL, the transformed lymphoid

cells reflect the altered expression of genes usually involved in the

normal development of B cells and T cells. Several studies indicate

that leukemic stem cells are present in certain types of ALL.

The exact cause of ALL is unknown. Research is going on all the

time into possible causes of this disease. Children with certain

genetic disorders, such as Down’s syndrome, are known to have a higher

risk of developing leukaemia. Brothers and sisters of a child with ALL

(particularly identical twins) have a slightly increased risk of

developing ALL themselves, although this risk is still small.

Like all cancers, ALL is not infectious and cannot be passed on

to other people.

B. GOALS & OBJECTIVES

GOALS:

After the completion of the study, we shall be able to: Utilize the

nursing process—which is composed of the five processes including

assessment, diagnosis, planning, implementation and evaluation.

OBJECTIVES:

We will utilize the nursing process by:

1. Providing comprehensive assessment of the client and the affected

area.

2. Giving appropriate clinical or nursing judgment—diagnosis.

3. Listing the prioritized nursing problems.

4. Planning appropriate nursing interventions that is related to the

problem of the client.

5. Implementing correctly the following:

a. Develop the family’s support system and their respective roles

in improving not only the client but also the preterm baby before and

after they placed in incubator.

b. Orient the client to improve her general status including her

nutrition and proper hygiene and teach her the proper ways to care for

her baby.

6. Evaluating the necessary outcomes like:

a. He listened attentively to what we imparted to him.

b. Adapting all nursing interventions.

 CHAPTER I
PATIENT'S PROFILE

A. DEMOGRAPHIC DATA

Name: Patient X
Age: 10 years old
Gender: Male
Status: Single
Nationality: Filipino
Birthdate: December 9, 2004
Religion: Baptists
Occupation: Student
Address: Tuba, Benguet
Date of Admission: March 3, 2015
Admitting Diagnosis: Anemia related to blood dyscrasia probably
hemolytic anemia

B. HEALTH HISTORY
1. Chief Complaints

2. Health History
A. Past Medical History
2 months PTA, the patient started to have productive cough
associated with colds undo currented fever. He was given Paracetamol
250/5 ml q4 that provided relief they sought consult to a PMD.
Diagnosis was not known by the mother but she was?? With unrecalled
cough syrup and antibiotic which they complied.
B. Present Medical History
1 month PTA, there was a reoccurrence of patients cough and still
with intermittent fever. They gain sought consult to a PMD who gave
them unrecalled cough syrup and weak and complains of early
fatigability and dizziness.
One week PTA up to present, condition persisted consult done.

C. Familial History
The most common illnesses that the family experiences are the
following: hypertension on the mother side only including her mother
who is hypertensive. While her father had no known history of
sickness.

D. Pediatric History

E. Immunization status
VACCINES # OF DOSE
BCG 1 Complete
HEPATITIS B 3 complete
DPT 3 complete
OPV 3 Complete
HIB 3 Complete
MEASLES 1 Complete
MMR 1 complete