Non-Hodgkin’s lymphoma

Non-Hodgkin's lymphoma is a neoplastic disease of cells of the lymphoreticular system. Classification of lymphomas based on predominant malignant cell and degree of malignant cell differentiation. These are common to men for over two to three times than women and can affect all age groups; the incidence increases with age. This is a lymph node involvement or extranodal disease at the time of diagnosis. This is associated to bone marrow invasion, anemia, thrombocytopenia, immune dysfunction and other type of infection.

The signs and symptoms are palpable lymph nodes, especially in the cervical, axillaries and groin area, body weakness, weight loss, high fever, chills, night sweats, pruritus, difficulty in breathing, unable to swallow food, edema in the extremities, vomiting, jaundice, and laryngeal paralysis. The complications can also enlargement of the spleen and enlargement of the liver. To confirm non-Hodgkin's lymphoma several diagnostic studies will undergo by the client. This is lymph node biopsy, reveals malignant lymphomas with absence of reed-Sternberg cells. Bone marrow aspirate and biopsy reveals metastasis to bone. Liver and renal function tests reveal any metastasis to liver and kidney. Ct scan reveals lymphoma in lymph nodes and organs.

To rule out the signs and symptoms analgesics had been prescribe but it usually starts in a low dose to avoid drug tolerance. Optimal skin hydration and protection for the skin to maintain skin integrity and decrease pruritus.

Treat fever symptomatically with antipyretics after infection is rule out. Protect the client from infection like doing hand washing, wearing protective gadgets and taking vitamins to boost the immune system. A rest period provided because clients are prone to body weakness.

The diet will be high protein and high caloric to enhance energy of the client. The meal should be attractive in a pleasant setting to gain attention of the client and able to increase and consume more food to improve nutritional status. Food needs to be cold to decrease the odor and stop the trigger for nausea. It should be a bland diet.

Extra blankets been provided to warm the clients body and minimize chills. Chamomile lotions applied to treat pruritus. When difficulty of breathing occurs, the head of the bed of the client elevated to promote lung expansion and good gas exchange.

If the client is unable to swallow the food, nasogastric tube is being inserted or an IV line to ensure proper nutrition. When the client vomits, antiemetic drugs are given and needs to be monitored because severe vomiting can lead to dehydration. Severe cases during the terminal stage, it is where medical practitioners handle the client more because anytime cardiac arrest occur and they need to insert endotracheal tube.

The family and other support system are part of the treatment especially when the terminal stage occurs. The prognosis is poor that is why learning and grieving process well indicated.