NURS 6501 Knowledge Check Psychological Disorders

Complete the Knowledge Check By Day 7 of Week 9

To complete this Knowledge Check:

Module 6 Knowledge Check

A ten-year-old boy is brought to clinic by his mother who states that the boy has been listless and not eating. She also notes that he has been easily bruising without trauma as he says he is too tired to go out and play. He says his bones hurt sometimes. Mother states the child has had intermittent fevers that respond to acetaminophen. Maternal history negative for pre, intra, or post-partum problems. Child’s past medical history negative and he easily reached developmental milestones. Physical exam reveals a thin, very pale child who has bruises on his arms and legs in no particular pattern. The APRN orders complete blood count (CBC), and complete metabolic profile (CMP). The CBC revealed Hemoglobin of 6.9/dl, hematocrit of 19%, and platelet count of 80,000/mm3. The CMP demonstrated a blood urea nitrogen (BUN) of 34m g/dl and creatinine of 2.9 mg/dl. The APRN recognizes that the patient appears to have acute leukemia and renal failure and immediately refers the patient to the Emergency Room where a pediatric hematologist has been consulted and is waiting for the boy and his mother. The diagnosis of acute lymphoblastic leukemia (ALL) was made after extensive testing.

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Question 1 of 2:

What is ALL?
Selected Answer:
ALL is a malignant bone marrow disease where there is a proliferation of early lymphoid precursors that replace the normal bone marrow hematopoietic cells. It is the most common type of leukemia in the US and cancer in children. The malignant cells (lymphoblasts) get arrested in the early development stages, which is caused by abnormal gene expression following abnormalities in the number of chromosomes or translocations of chromosomes. When the lymphoblasts proliferate, the number of normal elements in the bone marrow which produce other lines of blood cells decreases.  This explains why most patients usually present with thrombocytopenia, anemia, and neutropenia. In other instances, the lymphoblasts can also infiltrate beyond the bone marrow, to the lymph nodes, liver, and spleen, causing enlargement.
Correct Answer:
Acute lymphoblastic leukemia (ALL) 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 is the most common type of cancer and leukemia in children in the United States.

The malignant cells of acute lymphoblastic leukemia (ALL) are lymphoid precursor cells (ie, lymphoblasts) that are arrested in an early stage of development. This arrest is caused by an abnormal expression of genes, often as a result of chromosomal translocations or abnormalities of chromosome number. NURS 6501 Knowledge Check Psychological Disorders

These aberrant lymphoblasts proliferate, reducing the number of the normal marrow elements that produce other blood cell lines (red blood cells, platelets, and neutrophils). Consequently, anemia, thrombocytopenia, and neutropenia occur, although typically to a lesser degree than is seen in acute myeloid leukemia. Lymphoblasts can also infiltrate outside the marrow, particularly in the liver, spleen, and lymph nodes, resulting in enlargement of the latter organs.
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What’s Coming Up in Module 7?

Week 10 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders

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Module 7