leukemia nursing care plan

Leukemia is a type of cancer which affects the blood cells. This entails the proliferation of abnormal immature white blood cells. These cells are accumulated in the lymphoid tissues and bone marrow, and when a person have leukemia it reproduce uncontrollably and infiltrate the body tissues and blood vessels. This will eventually lead to malfunction due to hemorrhage, encroachment, or infection. This can be further classified as acute, which is rapidly growing; or chronic, which develops more gradually.


Type of Leukemia

Acute – this type of leukemia entails a profound percentage of such immature cells and tends to progress rapidly if chemotherapy is not provided. In fact, the case of acute leukemia is already considered as a medical emergency, which would often require hospitalization and initiation of therapy within hours of the time and diagnosis is made.

  • Acute Lymphoblastic Leukemia (ALL) – This type of leukemia is commonly seen in children but may also occur in adults. The body produces too much white blood cells that causes infections, anemia and bleeding.
  • Acute Myelogenous Leukemia (AML) – This affects the myeloid cells and grows quickly. The disease progresses faster than other types. It occurs in both adults and children. But is commonly seen in men that in women.

Chronic – this condition has a lower percentage of immature cells and also have a significantly higher proportion of mature cells. Unlike acute type, this condition may progress slowly and may also not cause manifestations for years.

  • Chronic Lymphocytic Leukemia (CLL) – It affects lymphoid cells and usually grows slowly. Most of the time diagnosed in men over 55 years old. The disease is slow in progression.
  • Chronic Myelogenous Leukemia (CML) – It is common in adults. This type affects lymphoid cells created in the bone marrow.

The percentage of immature cells and the proportion of mature cells, determines the distinction between acute leukemia and chronic leukemia; instead of the number of abnormal cells found in the blood or the bone marrow. 

Risk Factors

  • Predisposing
    • Hereditary
    • Congenital chromosomal abnormalities
    • Immunodeficiency
    • Gender
    • Genetic disorders
    • Chronic marrow dysfunction
  • Precipitating
    • Exposure to high levels of radiation
    • Chemicals and drugs
    • Previous cancer treatment
    • Exposure to certain chemicals
    • Smoking

Signs and Symptoms

  • Loss of appetite
  • Weight loss
  • Fatigue
  • Fever
  • Bleeding
    • Bleeding gums
    • Red spots on the skin
    • Widespread bruising, purple patches under the skin
    • Frequent or severe nose bleeds
    • Petechiae– red spots on skin
  • Anemia
    • Paleness
    • Malaise
    • Dizziness
    • Shortness of breath
    • Rapid heartbeat
  • Frequent infections
    • Cold sores
    • Urinary tract
    • Pneumonia
    • Gums
    • Infection in the anal area
  • Headache
  • Vomiting
  • Sore throat
  • Bone or joint pain
  • Night sweats
  • Swelling of the testicles
  • Vision problems
  • Abdominal discomfort or feeling of fullness
  • Bone or joint pain
  • Enlarged lymph nodes
  • Enlarged liver or spleen
      • Discomfort in the abdomen
      • Loss of appetite
      • Losing weight without trying


  • Stem cell transplant: an option is recommended for patient age 55 years old.
  • Chemotherapy: this option is often the main treatment for patients with leukemia and other forms of cancer.
  • Radiation therapy: most often use in preventing spread to the central nervous system as well as for treating the disease per se; and to prepare for stem cell transplant.
  • Targeted therapy: a treatment used for patients with Philadelphia treatment.
  • Supportive therapy: an intervention used for managing complications of treatment.

Supportive Care for Leukemia

Fatigue: this is a known symptoms when a patient have a low red blood cells, and this may require blood transfusion.

Infection: this develops due to low white blood cell count (neutropenia). Neutropenia is brought about by malfunction of bone marrow, or could be an effect of the chemotherapy treatment. Medications used for this symptoms are antibiotics and antifungal.

Abnormal bleeding: this transpire due to low platelet count. This is also brought about by malfunction of bone marrow, or could be an effect of the chemotherapy treatment. The treatment provided for this symptom is platelet transfusion to help slow or reduce bleeding.

Loss of appetite: this is a common symptoms for patients with leukemia, and it could result from the disease per se, fatigue or depression, and treatments.

Emotional health: during treatment, the patient may experience vast array of overwhelming emotions. Unexpected feelings or thoughts felt by the patients may include the following:

  • Adapting to lifestyle
  • Concern that the cancer will come back
  • Thinking about the possible effects of cancer to them, their family, friends, work, and other significant others.
  • Anxiety due to less contact with the health care team
  • Questioning self- worth, identity, and alterations in appearance

Diagnostic Studies

  • Blood tests
    • Carcinoembryonic antigen (CEA): May be elevated.
    • Cold agglutinins: May be elevated (more than 1:16) in lymphatic leukemia.
    • Cryoglobulins: Positive cryoglobulin findings may be present in patients with lymphocytic leukemia.
    • CBC: Indicates a normocytic, normochromic anemia.
      • Hemoglobin: May be less than 10 g/100 mL.
      • Reticulocytes: Count is usually low.
      • Platelet count: May be very low (less than 50,000/mm).
      • WBC: May be more than 50,000/cm with increased immature WBCs (“shift to left”). Leukemic blast cells may be present.
    • Peripheral blood smear: reveals blast immature leukocytes
    • Prothrombin time (PT)/activated partial thromboplastin time (aPTT): Prolonged.
    • LDH: May be elevated.
    • Serum/urine uric acid: May be elevated.
    • Serum muramidase (a lysozyme): Elevated in acute monocytic and myelomonocytic leukemias.
    • Serum copper: Elevated.
    • Serum zinc: Decreased.
  • Diagnostic test
    • Bone marrow aspiration and biopsy: bone marrow is full of leukemic cells
    • Lymph node biopsy: to detect spread
    • Chest x-ray and lymph node biopsies: May indicate degree of involvement.
    • Ultrasound: provides visualization of the affected organs.

Lumbar puncture – shows whether leukemic cells have infiltrated the CNS

Nursing Priorities

  1. Prevent infection during acute phases of disease/treatment.
  2. Maintain circulating blood volume.
  3. Alleviate pain.
  4. Promote optimal physical functioning.
  5. Provide psychological support.
  6. Provide information about disease process/prognosis and treatment needs.

Nursing Care Plans for Leukemias (Based on NANDA)

Nursing diagnosis: Risk for Infection

Risk factors may include

  • Inadequate secondary defenses: alterations in mature WBCs (low granulocyte and abnormal lymphocyte count), increased number of immature lymphocytes; immunosuppression, bone marrow suppression (effects of therapy/transplant)
  • Inadequate primary defenses (stasis of body fluids, traumatized tissue)
  • Invasive procedures
  • Malnutrition; chronic disease

Possibly evidenced by

Not applicable; presence of signs and symptoms establishes an actual diagnosis.

Desired outcomes/evaluation criteria—patient will:
  • Verbalize understanding of individual causative/risk factor(s).
  • Identify interventions to prevent/reduce risk of infection.
  • Demonstrate techniques, lifestyle changes to promote safe environment.
  • Achieve timely wound healing; be free of purulent drainage or erythema; be afebrile.
Nursing Interventions Rationale
Infection Protection


Place in private room. Screen/limit visitors as indicated. Prohibit use of live plants/cut flowers. Restrict fresh fruits and vegetables or make sure they are washed or peeled.

Protect patient from potential sources of pathogens/infection. Note: Profound bone marrow suppression, neutropenia, and chemotherapy place patient at great risk for infection.
Require good handwashing protocol for all personnel and visitors. Prevents cross-contamination/reduces risk of infection.
Monitor temperature. Note correlation between temperature elevations and chemotherapy treatments. Observe for fever associated with tachycardia, hypotension, subtle mental changes. Although fever may accompany some forms of chemotherapy, progressive hyperthermia occurs in some types of infections, and fever (unrelated to drugs or blood products) occurs in most leukemia patients. Note: Septicemia may occur without fever.
Prevent chilling. Force fluids, administer tepid sponge bath. Helps reduce fever, which contributes to fluid imbalance, discomfort, and CNS complications.
Encourage frequent turning and deep breathing. Prevents stasis of respiratory secretions, reducing risk of atelectasis/pneumonia.
Auscultate breath sounds, noting crackles, rhonchi; inspect secretions for changes in characteristics, e.g., increased sputum production or change in sputum color. Observe urine for signs of infection, e.g. cloudy, foul-smelling, or presence of urgency or burning with voids. Early intervention is essential to prevent sepsis/septicemia in immunosuppressed person.
Handle patient gently. Keep linens dry/wrinkle-free. Prevents sheet burn/skin excoriation.
Inspect skin for tender, erythematous areas; open wounds. Cleanse skin with antibacterial solutions. May indicate local infection. Note: Open wounds may not produce pus because of insufficient number of granulocytes.
Inspect oral mucous membranes. Provide good oral hygiene. Use a soft toothbrush, sponge, or swabs for frequent mouth care. The oral cavity is an excellent medium for growth of organisms and is susceptible to ulceration and bleeding.
Promote good perianal hygiene. Examine perianal area at least daily during acute illness. Provide sitz baths, using Betadine or Hibiclens if indicated. Avoid rectal temperatures, use of suppositories. Promotes cleanliness, reducing risk of perianal abscess; enhances circulation and healing. Note: Perianal abscess can contribute to septicemia and death in immunosupressed patients.
Coordinate procedures and tests to allow for uninterrupted rest periods. Conserves energy for healing, cellular regeneration.
Encourage increased intake of foods high in protein and fluids with adequate fiber. Promotes healing and prevents dehydration. Note: Constipation potentiates retention of toxins and risk of rectal irritation/tissue injury.


Nursing Intervention Rationale
Infection Protection 


Avoid/limit invasive procedures (e.g. venipuncture and injections) as possible.

Break in skin could provide an entry for pathogenic/potentially lethal organisms. Use of central venous lines (e.g., tunneled catheter or implanted port) can effectively reduce need for frequent invasive procedures and risk of infection. Note: Myelosuppression may be cumulative in nature, especially when multiple drug therapy (including steroids) is prescribed.

Monitor laboratory studies, e.g.:

CBC, noting whether WBC count falls or sudden changes occur in neutrophils;

Decreased numbers of normal/mature WBCs can result from the disease process or chemotherapy, compromising the immune response and increasing risk of infection.
Gram’s stain cultures/sensitivity. Verifies presence of infections; identifies specific organisms and appropriate therapy.
Review serial chest x-rays. Indicator of development/resolution of respiratory complications.
Prepare for/assist with leukemia-specific treatments such as chemotherapy, radiation, and/or bone marrow transplant. Leukemia is usually treated with a combination of these agents, each requiring specific safety precautions for patient and care providers.
Administer medications as indicated, e.g.: antibiotics; May be given prophylactically or to treat specific infection.
Colony-stimulating factors: sargramostim (Leukine). Restores WBCs destroyed by chemotherapy and reduces risk of severe infection and death in certain types of leukemia.
Avoid use of aspirin-containing antipyretics. Aspirin can cause gastric bleeding and further decrease platelet count.
Provide nutritious diet, high in protein and calories, avoiding raw fruits, vegetables, or uncooked meats. Proper nutrition enhances immune system. Minimizes potential sources of bacterial contamination.

Nursing diagnosis: Risk for deficient fluid volume

Risk factors may include

  • Excessive losses, e.g., vomiting, hemorrhage, diarrhea
  • Decreased fluid intake, e.g., nausea, anorexia
  • Loss of fluid through abnormal routes, e.g. drains
  • Increased fluid need, e.g., hypermetabolic state, fever; predisposition for kidney stone formation/tumor lysis syndrome
  • Insufficient knowledge regarding the cause and prevention of fluid deficit
  • Medication, e.g. diuretics

Possibly evidenced by

Not applicable; presence of signs and symptoms establishes an actual diagnosis.

Desired outcomes/evaluation criteria—patient will:
  • Demonstrate adequate fluid volume, as evidenced by stable vital signs; palpable pulses; urine output, specific gravity, and pH within normal limits.
  • Identify individual risk factors and appropriate interventions.
  • Initiate behaviors/lifestyle changes to prevent development of dehydration.
Nursing Intervention Rationale
Fluid Management


Monitor I&O. Calculate insensible losses and fluid balance. Note decreased urine output in presence of adequate intake. Measure specific gravity and urine pH.

Tumor lysis syndrome occurs when destroyed cancer cells release toxic levels of potassium, phosphorus, and uric acid. Elevated phosphorus and uric acid levels can cause crystal formation in the renal tubules, impairing filtration and leading to renal failure.
Weigh daily. Measure of adequacy of fluid replacement and kidney function. Continued intake greater than output may indicate renal insult/obstruction.

Monitor BP and HR.

Changes may reflect effects of hypovolemia (bleeding/dehydration).
Evaluate skin turgor, capillary refill, and general condition of mucous membranes. Indirect indicators of fluid status/hydration.
Note presence of nausea, fever.  

Affects intake, fluid needs, and route of replacement.

Encourage fluids of up to 3–4 L/day when oral intake is resumed. Promotes urine flow, prevents uric acid precipitation, and enhances clearance of antineoplastic drugs.
Nursing Intervention Rationale
Bleeding Precautions


Inspect skin/mucous membranes for petechiae, ecchymotic areas; note bleeding gums, frank or occult blood in stools and urine; oozing from invasive-line sites.

Suppression of bone marrow and platelet production places patient at risk for spontaneous/uncontrolled bleeding.
Implement measures to prevent tissue injury/bleeding, e.g., gentle brushing of teeth or gums with soft toothbrush, cotton swab, or sponge-tipped applicator; using electric razor and avoiding sharp razors when shaving; avoiding forceful nose blowing and needlesticks when possible; using sustained pressure (sandbags or pressure dressings) on oozing puncture/IV sites. Fragile tissues and altered clotting mechanisms increase the risk of hemorrhage following even minor trauma.
Limit oral care to mouthwash if indicated (a mixture of 1/4 tsp baking soda or salt in 4–8 oz water or hydrogen peroxide in water). Avoid mouthwashes with alcohol. When bleeding is present, even gentle brushing may cause more tissue damage. Alcohol has a drying effect and may be painful to irritated tissues.
Provide soft diet. May help reduce gum irritation.
Fluid Management


Administer IV fluids as indicated.

Maintains fluid/electrolyte balance in the absence of oral intake; prevents or minimizes tumor lysis syndrome, reduces risk of renal complications.
Administer medications as indicated, e.g.

Antiemetics: 5-HT3 receptor antagonist drugs such as ondansetron (Zofran) or granisetron (Kytril)

Relieves nausea/vomiting associated with administration of chemotherapy agents.
Allopurinol (Zyloprim) Improves renal excretion of toxic byproducts from breakdown of leukemia cells. Reduces the chances of nephropathy as a result of uric acid production.
Potassium acetate or citrate, sodium bicarbonate May be used to alkalinize the urine, preventing or minimizing tumor lysis syndrome/kidney stones.
Stool softeners. Helpful in reducing straining at stool with trauma to rectal tissues.
Bleeding Precautions

Monitor laboratory studies, e.g. platelets, Hb/Hct, clotting.

When the platelet count is less than 20,000/mm (because of proliferation of WBCs and/or bone marrow suppression secondary to antineoplastic drugs), patient is prone to spontaneous life-threatening bleeding. Decreasing Hb/Hct is indicative of bleeding (may be occult).

Administer RBCs, platelets, clotting factors.

Restores/normalizes RBC count and oxygen-carrying capacity to correct anemia. Used to prevent/treat hemorrhage.
Maintain external central vascular access device (subclavian or tunneled catheter or implanted port). Eliminate peripheral venipuncture as source of bleeding.
Administer medications, e.g. oral contraceptives Minimizes blood loss by stopping or slowing menstrual flow.

Nursing diagnosis: Acute pain

  • Physical agents, e.g. enlarged organs/lymph nodes, bone marrow packed with leukemic cells
  • Chemical agents, e.g. antileukemic treatments
  • Psychological manifestations, e.g. anxiety, fear

Possibly evidenced by

  • Subjective
    • Verbal report of pain; coded report [may be less from clients younger than age 40, men, and some cultural groups]
    • Changes in appetite
  • Objective
    • Observed evidence of pain
    • Guarding behavior; protective gestures; positioning to avoid pain
    • Facial mask; sleep disturbance (eyes lack luster, beaten look, fixed or scattered movement, grimace)
    • Expressive behavior (e.g., restlessness, moaning, crying, vigilance, irritability, sighing)
    • Distraction behavior (e.g., pacing, seeking out other people and/or activities, repetitive activities)
    • Change in muscle tone (may span from listless [flaccid] to rigid)
    • Diaphoresis; change in blood pressure/heart rate/respiratory rate; pupillary dilation
    • Self-focusing; narrowed focus (altered time perception, impaired thought process, reduced interaction with people and environment)

Desired outcomes/evaluation criteria—patient will:

  • Report pain is relieved/controlled.
  • Follow prescribed pharmacological regimen.
  • Verbalize non-pharmacologic methods that provide relief.
  • Demonstrate use of relaxation skills and diversional activities, as indicated, for individual situation
Nursing Intervention Rationale
Pain Management


Investigate reports of pain. Note changes in degree (use scale of 0–10) and site.


Helpful in assessing need for intervention; may indicate developing complications.

Monitor vital signs, note nonverbal cues, e.g. muscle tension, restlessness. May be useful in evaluating verbal comments and effectiveness of interventions.
Provide quiet environment and reduce stressful stimuli, e.g. noise, lighting, constant interruptions. Promotes rest and enhances coping abilities.
Place in position of comfort and support joints, extremities with pillows/padding. May decrease associated bone/joint discomfort.
Reposition periodically and provide/assist with gentle ROM exercises. Improves tissue circulation and joint mobility.
Provide comfort measures (e.g. massage, cool packs) and psychological support (e.g. encouragement, presence). Minimizes need for/enhances effects of medication.
Review/promote patient’s own comfort interventions, e.g. position, physical activity/nonactivity, and so forth. Successful management of pain requires patient involvement. Use of effective techniques provides positive reinforcement, promotes sense of control, and prepares patient for interventions to be used after discharge.
Evaluate and support patient’s coping mechanisms. Using own learned perceptions/behaviors to manage pain can help patient cope more effectively.
Encourage use of stress management techniques, e.g. relaxation/deep-breathing exercises, guided imagery, visualization; Therapeutic Touch. Facilitates relaxation, augments pharmacological therapy, and enhances coping abilities.
Assist with/provide diversional activities, relaxation techniques. Helps with pain management by redirecting attention.

Monitor uric acid level as appropriate.

Rapid turnover and destruction of leukemic cells during chemotherapy can elevate uric acid, causing swollen painful joints in some patients. Note: Massive infiltration of WBCs into joints can also result in intense pain.
Administer medications as indicated:

Analgesics, e.g. acetaminophen (Tylenol)

Given for mild pain not relieved by comfort measures. Note: Avoid aspirin-containing products because they may potentiate hemorrhage.
Opioids, e.g., codeine, morphine, hydromorphone (Dilaudid); Used around-the-clock, rather than prn, when pain is severe. Note: Use of patient-controlled analgesia (PCA) is beneficial in preventing peaks and valleys associated with intermittent drug administration and increases patient’s sense of control.
Antianxiety agents, e.g., diazepam (Valium), lorazepam (Ativan).  May be given to enhance the action of analgesics/opioids.

Nursing diagnosis: Activity intolerance

May be related to

  • Generalized weakness; reduced energy stores, increased metabolic rate from massive production of leukocytes
  • Sedentary lifestyle
  • Bedrest/immobilitY
  • Imbalance between oxygen supply and demand (anemia/hypoxia)
  • Therapeutic restrictions (isolation/bedrest); effect of drug therapy

Possibly evidenced by

  • Subjective
    • Verbal report of fatigue/weakness
    • Exertional discomfort/dyspnea
  • Objective
    • Abnormal heart rate/blood pressure response to activity
    • Electrocardiographic changes reflecting arrhythmias/or ischemia [Pallor, cyanosis]
Functional Level Classification (Gordon, 1987):
  • Level I: Walk, regular pace, on level indefinitely; one flight or more but more short of breath than normally
  • Level II: Walk one city block [or] 500 ft on level; climb one flight slowly without stopping
  • Level III: Walk no more than 50 ft on level without stopping; unable to climb one flight of stairs without stopping
  • Level IV: Dyspnea and fatigue at rest

Desired outcomes/evaluation criteria—patient will:

  • Identify negative factors affecting activity tolerance and eliminate or reduce their effects when possible.
  • Use identified techniques to enhance activity tolerance.
  • Participate willingly in necessary/desired activities.
  • Report measurable increase in activity tolerance.
  • Demonstrate a decrease in physiological signs of intolerance (e.g., pulse, respirations, and blood pressure remain within client’s normal range).
  • Desired Outcomes/Evaluation
Nursing Intervention Rationale
Energy Management 


Evaluate reports of fatigue, noting inability to participate in activities or ADLs.

Effects of leukemia, anemia, and chemotherapy may be cumulative (especially during acute and active treatment phase), necessitating assistance.
Encourage patient to keep a diary of daily routines and energy levels, noting activities that increase fatigue. Helps patient prioritize activities and arrange them around fatigue pattern.
Provide quiet environment and uninterrupted rest periods. Encourage rest periods before meals. Restores energy needed for activity and cellular regeneration/tissue healing.
Implement energy-saving techniques, e.g., sitting, rather than standing, use of shower chair. Assist with ambulation/other activities as indicated. Maximizes available energy for self-care tasks.
Schedule meals around chemotherapy. Give oral hygiene before meals and administer antimetics as indicated. May enhance intake by reducing nausea.
Recommend small, nutritious, high-protein meals and snacks throughout the day. Smaller meals require less energy for digestion than larger meals. Increased intake provides fuel for energy.

Provide supplemental oxygen.

Maximizes oxygen available for cellular uptake, improving tolerance of activity.

Nursing Diagnosis: Knowledge Deficit regarding disease, prognosis, treatment, self-care, and discharge needs

May be related to:

  • Lack of exposure to resources
  • Information misinterpretation/lack of recall
  • Information misinterpretation [inaccurate/incomplete information presented]
  • Unfamiliarity with information resources
  • Cognitive limitation
  • Lack of interest in learning [client’s request for no information]

Possibly evidenced by:

  • Subjective
    • Verbalization of the problem
  • Objective
    • Inaccurate follow-through of instruction/performance of test
    • Inappropriate/exaggerated behaviors (e.g., hysterical, hostile, agitated, apathetic)
Desired outcomes/evaluation criteria—patient will:
  • Participate in learning process.
  • Identify interferences to learning and specific action(s) to deal with them.
  • Exhibit increased interest/assume responsibility for own learning by beginning to look for information and ask questions.
  • Verbalize understanding of condition/disease process and treatment.
  • Identify relationship of signs/symptoms to the disease process and correlate symptoms with causative factors.
  • Perform necessary procedures correctly and explain reasons for the actions.
  • Initiate necessary lifestyle changes and participate in treatment regimen.
Nursing Intervention Rationale
Review with patient/SO understanding of specific diagnosis, treatment alternatives, and future expectations. Validates current level of understanding, identifies learning needs, and provides knowledge base from which patient can make informed decisions.
Determine patient’s perception of cancer and cancer treatment(s); ask about patient’s own/previous experience or experience with other people who have (or had) cancer. Aids in identification of ideas, attitudes, fears, misconceptions, and gaps in knowledge about cancer
Provide clear, accurate information in a factual but sensitive manner. Answer questions specifically, but do not bombard with unessential details.


Helps with adjustment to the diagnosis of cancer by providing needed information along with time to absorb it. Note: Rate and method of giving information may need to be altered to decrease patient’s anxiety and enhance ability to assimilate information.
Provide anticipatory guidance with patient/SO regarding treatment protocol, length of therapy, expected results, possible side effects. Be honest with patient Patient has the “right to know” (be informed) and participate in decision tree. Accurate and concise information helps to dispel fears and anxiety, helps clarify the expected routine, and enables patient to maintain some degree of control.
Ask patient for verbal feedback, and correct misconception about individual’s type of cancer and treatment Misconceptions about cancer may be more disturbing than facts and can interfere with treatments/delay healing.
Outline normally expected limitations (if any) on ADLs (e.g., difficulty cooking meals when nauseated/fatigued, limit sun exposure, alcohol intake; loss of work time because of effects of treatments) Enables patient/SO to begin to put limitations into perspective and plan/adapt as indicated.


Provide written materials about cancer, treatment, and available support systems Anxiety and preoccupation with thoughts about life and death often interfere with patient’s ability to assimilate adequate information. Written, take-home materials provide reinforcement and clarification about information as patient needs it.
Stress importance of continuing medical follow-up. Provides ongoing monitoring of progression/ resolution of disease process and opportunity for timely diagnosis and treatment of complications.
Encourage periodic review of advance directives. Promote inclusion of family/SO in decision-making process. Patient/family/SO need to re-evaluate choices as condition changes (for better/worse) and treatment options become available or are exhausted.


  1. Canobbio, M. (2006). Mosby’s handbook of patient teaching. Elsevier Health Sciences
  2. Leukemia. (2015). Canadian Cancer Society. Retrieved October 27, 2015 from http://www.cancer.ca/en/cancer-information/cancer-type/leukemia/leukemia/?region=on.
  3. Markman, M., Loguidice, C. & Lammersfeld, C. (2013). Cancer nutrition and recipes for dummies. Hoboken, NJ: John Wiley & Sons.

This page was last edited on 6 June 2020

This community comprises professional nurses who possess exceptional literary skills. They come together to share their expertise in theoretical and clinical knowledge, nursing tips, facts, statistics, healthcare information, news, disease data, care plans, drugs, and all aspects encompassed by the field of nursing. The information presented here is provided by individual authors and is expressed with courtesy. It is important to note that the views expressed on various topics may not necessarily represent those of the entire community. The articles submitted to this platform are original, meticulously checked for minor typographical errors, and formatted to ensure compatibility with the site. The site's primary goal is to consistently enhance and disseminate healthcare information that is pertinent to the ever-evolving world we live in today.


Please enter your comment!
Please enter your name here