Discharge And Home Healthcare Guidelines

Although they are cured of the disease, patients who survive Hodgkin's disease continue to have immune defects that persist throughout life. Defects include transiently depressed antibody production, decreased polymorphonuclear chemotaxis, decreased antigen-induced T-cell proliferation, and changes in delayed hypersensitivity. Coupled with the sometimes lingering aftereffects of radiation and chemotherapy, the patient needs to maintain infection vigilance even after remission is obtained. Teach the patient lifelong strategies to avoid infection.

Patients may have other complications for up to 25 years after mantle radiation therapy, including hypothyroidism, Graves' disease, and thyroid cancer. Irradiation can also cause pulmonary and pericardial fibrosis and coronary artery changes, and it may increase the risk for the development of solid tumors such as lung cancer, breast cancer, and others. Explain the presenting symptoms of the disorder, provide written information for the patient, and encourage yearly physicals to maintain follow-up. Because infertility may be a complication of chemotherapy, men may want to think of sperm banking before treatments, although many have sperm dysfunction at diagnosis.

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