Multiple Myeloma | Nursing Care Plan.

 

Definition

Multiple Myeloma is a type of blood cancer that primarily affects plasma cells in the bone marrow. In this disease, abnormal plasma cells multiply uncontrollably, which can lead to bone damage, weakened immunity, and other health complications.

Causes

The exact cause of multiple myeloma is unknown. However, factors that may contribute to the disease include genetic mutations in plasma cells, environmental influences, exposure to radiation, and immune system deficiencies.

Risk Factors

• Age: More common in older adults, particularly those over 65.
• Gender: Slightly more common in men.
• Family History: A family history of multiple myeloma can increase risk.
• Ethnicity: Higher prevalence in African-Americans.
• Exposure to Chemicals and Radiation: Such as pesticides and certain industrial chemicals.
• Obesity: Linked with increased risk due to overall health impact.

Treatment

• Chemotherapy: Medications to kill or stop the growth of abnormal plasma cells.
• Targeted Therapy: Drugs that specifically target cancerous plasma cells.
• Immunotherapy: Boosts the immune system’s ability to fight myeloma cells.
• Stem Cell Transplant: Involves replacing diseased bone marrow with healthy stem cells.
• Radiation Therapy: Uses high-energy beams to reduce tumors.
• Corticosteroids: Help manage inflammation and reduce immune system activity.
• Supportive Therapies: Pain management, bisphosphonates for bone health, and hydration.

Nursing Care Plan

1. Risk for Infection

   • Expected Outcome: Patient remains free from infection.
   • Interventions: Monitor temperature, enforce strict hand hygiene, educate on infection prevention (e.g., avoiding crowded areas).
   • Rationale: Weakened immunity due to multiple myeloma and treatments increases infection risk.
   • Evaluation: Patient remains infection-free and follows infection control practices.

2. Pain Management

   • Expected Outcome: Patient experiences pain relief and comfort.
   • Interventions: Provide prescribed analgesics, ensure comfortable positioning, educate on heat/cold therapy for pain relief.
   • Rationale: Bone damage from myeloma can cause severe pain, making pain management crucial for quality of life.
   • Evaluation: Patient reports reduced pain and improved comfort.

3. Risk for Skin Integrity Impairment

   • Expected Outcome: Patient’s skin remains intact without signs of pressure sores.
   • Interventions: Regularly assess skin for pressure points, reposition patient frequently if bedridden, use soft bedding.
   • Rationale: Myeloma treatments can increase skin fragility and risk of breakdown.
   • Evaluation: Skin remains healthy and free from sores.

4. Impaired Physical Mobility

   • Expected Outcome: Patient maintains or improves mobility within physical limits.
   • Interventions: Assist with ambulation, encourage range of motion exercises, educate on fall prevention.
   • Rationale: Bone pain and fatigue can limit mobility, increasing the risk of falls.
   • Evaluation: Patient ambulates safely and understands mobility precautions.

5. Knowledge Deficit

   • Expected Outcome: Patient understands multiple myeloma, treatment, and self-care needs.
   • Interventions: Provide disease and treatment information, discuss medication and side effects, educate on diet and signs of complications.
   • Rationale: Patient education empowers self-care and early recognition of complications.
   • Evaluation: Patient can explain the disease, treatment plan, and self-care requirements.

Prognosis

The prognosis for multiple myeloma varies depending on factors such as the stage at diagnosis, response to treatment, and overall health. While multiple myeloma is generally considered incurable, treatment advancements have significantly improved survival rates, allowing many patients to live longer with effective symptom management.

Complications

• Bone Fractures: Due to weakened bones from cancerous cells.
• Infections: Increased due to weakened immune system.
• Kidney Damage: Myeloma cells produce substances that can harm the kidneys.
• Anemia: Caused by reduced production of healthy blood cells.
• Hypercalcemia: High calcium levels in the blood due to bone destruction.
• Neuropathy: Nerve damage caused by certain medications or disease progression.