Nursing Department

Case Study: Lymphoma

Introduction

Lymphoma is a complex form of cancer that arises in the lymphatic system, a vital component of the
body's immune defense. This condition occurs when abnormal white blood cells, known as lymphocytes,
undergo unchecked growth, leading to the formation of tumors. Lymphoma is broadly categorized into
Hodgkin lymphoma and non-Hodgkin lymphoma, with each category encompassing multiple distinct
subtypes, each with its own unique characteristics.

Symptoms of lymphoma can manifest as painless swelling of lymph nodes, unexplained fevers,
significant weight loss, and drenching night sweats. Diagnosing lymphoma typically involves a
comprehensive assessment encompassing physical examinations, imaging studies, and biopsies to
confirm the presence of cancerous cells. Treatment approaches for lymphoma are highly individualized
and may comprise a combination of chemotherapy, radiation therapy, immunotherapy, targeted therapy,
and stem cell transplantation. It is imperative for individuals to promptly seek medical attention to receive
an accurate diagnosis and tailored treatment plan.

In relations to patient's case, a 31-year-old man was diagnosed with lymphoma subsequent to his second
thoracentesis procedure, which revealed concerning findings. The diagnosis of lymphoma was confirmed
through a biopsy, a procedure that entailed the extraction of tissue from the swollen lymph nodes located
in his right neck. This case study aims to comprehensively investigate the patient's extensive medical
history as a potential influencing factor in the development of lymphoma, taking into account various
aspects such as previous medical conditions, genetic predispositions, and environmental factors.
Additionally, the study will delve into the intricate diagnostic elements, including imaging tests, blood
work, and pathology reports, that contributed to the conclusive diagnosis.

Demographic data
Name: Jose Mari Acaybal
Age:31
Sex: Male
Religion: Roman Catholic
Occupation: Seaman
Birthday: April 06, 1993
Marital Status: Single

History of present health concern

Lymphoma was diagnosed in December after his healthcare providers become suspected the abnormal
multiple swelling in his chest, Lymphoma was diagnosed in December after his healthcare providers
suspected abnormal swelling in his chest, underarms, and neck.

1
 Nursing Department
Past Health History
 Got pulmonary edema in September and November 2023. The patient underwent thoracentesis in
the said months due to a recurring pulmonary edema.

Family health history

 His mother has a history of hypertension

Lifestyle and health practices (before and after diagnosis)

Before
 Heavy drinker
 Smoked at least 10 boxes of cigarettes in 1 month
After
 Stop his vices
 Avoid raw foods
 Eat more vegetables and fruits

Diagnosis
 Lymphoma

Diagnostic findings/procedures
 Lymph node biopsy, CT scan, X-ray, blood test

Medication
Prednisone
- used to reduce inflammation and lower the body's immune response to help lessen the side effects
of chemotherapy drugs

Side Effects/ Adverse Effects

 CNS: euphoria, headache, insomnia,
 confusion, psychosis
 CV: CHF (congestive heart failure), edema
 GI: nausea, vomiting, peptic ulcer
 Musculoskeletal: muscle weakness, delayed wound healing, muscle wasting, osteoporosis, aseptic
necrosis
 of bone, spontaneous factors.
 Endocrine: cushingoid features, growth suppression in children, carbohydrate intolerance,
hyperglycemia.
 Special senses: cataracts
 Hematologic: leukocytosis

Contraindications
 Prednisone is contraindicated in patients with documented hypersensitivity to the drug or
components of the formulation. Contraindications to the administration of prednisone include the

2
 Nursing Department
presence of systemic fungal infections. Administering live or live-attenuated vaccines is also
contraindicated with the administration of immunosuppressive prednisone doses.
 Systemic fungal infections and known hypersensitivity

Nursing Responsibility
 Establish baseline and continuing data regarding BP, I&O ratio and pattern, weight, and sleep
pattern.
 Check and record BP during close stabilization period at least 2 times daily.
 Lab tests: obtain fasting glucose, serum electrolytes, and routine laboratory studies at regular
intervals
 during long-term steroid therapy.
o Be aware that older adult patients and patients with low serum albumin are especially
susceptible to adverse
 effects because of excess circulating free glucocorticoids.
o Be alert to signs of hypocalcemia
o Be alert to possibility of masked affection and delayed healing
o Be aware that a slight weight gain and improved appetite is expected
o Avoid or minimize alcohol and caffeine may contribute to steriod-ulcer development in
long term.

Treatment
Chemotherapy
 it is effective in targeting rapidly dividing cancer cells, which are characteristic of lymphoma. By
using powerful drugs to destroy cancer cells throughout the body, chemotherapy can help to
control the growth of lymphoma and even induce remission.
Nursing management
 The nursing management for lymphoma involves providing patient education about the disease
and its treatment options, monitoring for symptoms and side effects of treatment, assisting with
pain management, providing emotional support, and coordinating care with other healthcare
professionals. It also includes educating patients about the importance of maintaining a healthy
lifestyle and adhering to their treatment plan, as well as monitoring for and managing any
potential complications. Additionally, nurses play a key role in advocating for their patients and
ensuring they receive comprehensive and compassionate care throughout the treatment process.

Prognosis

 the 5-year relative survival rate for stage 1 Hodgkin’s lymphoma is 93%, and for stage 4, it’s
83%.
 states that the 5-year relative survival rate is 73%. For stage 4 NHL, it’s 58%.

Health teaching
For Hodgkin
 Take all medicines as directed.
 Understand what you can and can’t do.

3
 Nursing Department
 Balance rest with activity. Take short naps during the day if you're tired. But try to move around
and walk as much as you can.
 Keep your follow-up appointments.
 Call your healthcare provider if you have any questions or are concerned about any symptoms.
Non-Hodgkin
 Take all medicines as instructed.
 Understand what you can and can’t do.
 Balance rest with activity. Take naps during the day, if you are tired. But try to move around and
walk as much as possible.
 Keep your follow-up appointments.
 Know how to reach your healthcare provider's office after office hours and on weekends and
holidays.
 Call your healthcare provider if you have any questions or are concerned about any symptoms.