Leukemia & Fluid Vol Deficit

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Hi all,

Was wondering if a smart cookie out there could help me with an assignment of mine. It's a case study - patient with AML who has been receiving chemo, presented to ED with vomiting & unable to keep fluids down. I'm doing a care plan for fluid vol. deficit which is fine, but one of the questions i need to cover in my essay is:

"Briefly explain why fluid volume deficit occurs in AML eg. what pathophysiological processes occur in AML and how do these processes lead to fluid volume deficit cues" ???

Obviously, he has FVD because of his vomiting etc, and will have electrolyte imbalances because of the vomiting also, I also found some journals that talk about how acute leukemia can cause electrolyte imbalances.

But.....I can't find anything on how leukemia would cause a fluid deficit other than the secondary effect of the vomiting.... am I missing something????

Thanks all !!

-Amy- :wink2:

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Specializes in Critical Care, Cardiothoracics, VADs.

http://www.nephrology.uoi.gr/uliko/Dimosievseis_engl_pdf/131.pdf#search=%22hypovolemia%20and%20AML%22

That was an article with some info about it. One reason would be the incidence of renal failure in pts with acute leukemia.

The other obvious thing is the bleeding propensity which would lead to reduced circulating volume. I guess another thing would be if they were treated with apheresis.

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Specializes in med/surg, telemetry, IV therapy, mgmt.

you will find some information about acute leukemia and it's treatment here:

http://www.fpnotebook.com/hem124.htm - acute leukemia

the fluid loss will be due to vomiting, bleeding, loss of fluid through sweating if the patient is having night sweats or temperatures are fluctuating a lot. it can also be secondary to the side effects of certain specific chemotherapy drugs that cause diuresis. leukemia patients in particular produce a lot of uric acid as a by-product of protein catabolism which is accelerated in this disease. the kidneys will work diligently to flush this waste product out of the system. if enough fluid is not present, the patient will get dehydrated. it can result in uric acid precipitates forming in the kidneys which can eventually cause damage to the organ causing even more problems with fluid and electrolyte balances.

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Thanks so much for your help !! :) I will dedicate my pass mark to you guys

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