Leukemia — NCLEX Cheat Sheet
↑↑ immature WBCs, ↓ everything elseAlso known as: blood cancer · white blood cell cancer · cancer of the blood · bone marrow cancer
Use this quick-reference guide to spot, treat, and prevent Leukemia on the NCLEX. Keep it handy during review and on exam day!
🩺📒 The 1-minute cheat sheet
📌 Mech
- malignant immature WBC overproduce
- crowd out RBC, plt, normal WBC
🩺 Signs
- infection (↓functional WBC)
- bleeding/bruising (↓platelets)
- fatigue, pallor (↓RBC), bone pain
🧪 Labs
- ↑↑WBC blasts, ↓Hgb ↓platelets
- bone marrow biopsy confirms
✅ Do
- neutropenic + bleeding precautions
- private room, no fresh flowers/raw
- report fever IMMEDIATELY = emergency
📚 Leukemia — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Key points
Understand these first- Overgrowth of immature leukocytes crowds out red cells, platelets, and normal white cells in the marrow.
- Despite a high WBC count, the cells are nonfunctional, so infection risk is high.
- Anemia causes fatigue, pallor, and dyspnea; thrombocytopenia causes bruising, petechiae, and bleeding.
- Bone and joint pain occur from marrow expansion, along with fever and night sweats.
- Hepatomegaly, splenomegaly, and lymphadenopathy are common.
- Diagnosis is confirmed by bone marrow aspiration showing blast cells.
Nursing priorities
What to do, in order- Implement neutropenic precautions and protect the patient from infection (handwashing, private room, no fresh flowers/raw produce).
- Institute bleeding precautions for low platelets: soft toothbrush, electric razor, no IM injections, no aspirin.
- Monitor temperature closely; a fever may be the only sign of infection.
- Administer chemotherapy, transfusions, and growth factors as prescribed and monitor for tumor lysis.
- Provide meticulous oral care and skin care to prevent breakdown and infection portals.
Red flags — report now
Escalate immediately- Report a temperature of 100.4 F (38 C) or higher; neutropenic fever is a medical emergency.
- Report active bleeding, new petechiae/bruising, or signs of intracranial bleed (headache, vision changes, altered mental status).
- Report signs of tumor lysis syndrome (hyperkalemia, hyperphosphatemia, hyperuricemia) after starting chemotherapy.
Labs & values
Numbers to know- WBC (normal 5,000-10,000/mm3) markedly increased or decreased with blasts present
- Platelets (normal 150,000-400,000/mm3) decreased
- Hemoglobin (normal 12-18 g/dL) decreased
- Absolute neutrophil count (ANC) often decreased
Patient teaching
What patients must know- Avoid crowds, sick contacts, and anyone with recent live vaccines; report fever or signs of infection immediately.
- Use a soft toothbrush and electric razor and avoid aspirin/NSAIDs and contact activities while platelets are low.
- Maintain good nutrition and hydration, and keep all follow-up and blood-count appointments.
❓ Leukemia: NCLEX FAQs
What are the priority nursing interventions for Leukemia?
Implement neutropenic precautions and protect the patient from infection (handwashing, private room, no fresh flowers/raw produce). Institute bleeding precautions for low platelets: soft toothbrush, electric razor, no IM injections, no aspirin. Monitor temperature closely; a fever may be the only sign of infection. Administer chemotherapy, transfusions, and growth factors as prescribed and monitor for tumor lysis.
What are the warning signs of Leukemia a nurse must report?
Report a temperature of 100.4 F (38 C) or higher; neutropenic fever is a medical emergency. Report active bleeding, new petechiae/bruising, or signs of intracranial bleed (headache, vision changes, altered mental status). Report signs of tumor lysis syndrome (hyperkalemia, hyperphosphatemia, hyperuricemia) after starting chemotherapy.
What do I need to know about Leukemia for the NCLEX?
Overgrowth of immature leukocytes crowds out red cells, platelets, and normal white cells in the marrow. Despite a high WBC count, the cells are nonfunctional, so infection risk is high. Anemia causes fatigue, pallor, and dyspnea; thrombocytopenia causes bruising, petechiae, and bleeding. Bone and joint pain occur from marrow expansion, along with fever and night sweats.
What patient teaching is important for Leukemia?
Avoid crowds, sick contacts, and anyone with recent live vaccines; report fever or signs of infection immediately. Use a soft toothbrush and electric razor and avoid aspirin/NSAIDs and contact activities while platelets are low. Maintain good nutrition and hydration, and keep all follow-up and blood-count appointments.
Quick Tip
Overgrowth of immature leukocytes crowds out red cells, platelets, and normal white cells in the marrow.
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