Multiple Myeloma Nursing Diagnosis & Care Plan

Multiple Myeloma is a type of cancer that affects the plasma cells in bone marrow. It is a challenging condition that requires a multidisciplinary approach to treatment and care.

Nursing diagnosis is an essential component of this approach, as it helps nurses to identify the patient’s needs, set goals, and develop an individualized care plan. In this article, we will explore the Multiple Myeloma Nursing Diagnosis, including symptoms, treatment, and care.

What is Multiple Myeloma Nursing Diagnosis?

Multiple Myeloma Nursing Diagnosis is a process used by nurses to identify the patient’s health needs, set goals, and develop an individualized care plan.

The diagnosis involves a comprehensive assessment of the patient’s physical, emotional, and psychological needs, as well as their social support system. The goal of the nursing diagnosis is to identify the patient’s health status, potential health problems, and their ability to cope with the disease.

Symptoms of Multiple Myeloma:

The symptoms of Multiple Myeloma may vary from person to person, depending on the stage of the disease. Some common symptoms include:

  • Bone pain, especially in the back, ribs, and hips.
  • Fatigue and weakness
  • Increased susceptibility to infections
  • Anemia
  • Kidney problems
  • Nausea and vomiting
  • Constipation
  • Loss of appetite
  • Confusion or mental fogginess
  • Unexplained weight loss

Treatment for Multiple Myeloma:

The treatment for Multiple Myeloma may include chemotherapy, radiation therapy, bone marrow transplant, or a combination of these. The choice of treatment depends on several factors, including the stage of the disease, the patient’s age, and overall health. Nurses play a vital role in supporting the patient during treatment and managing side effects. Here are some common treatments for Multiple Myeloma:

  • Chemotherapy: This treatment involves using drugs to kill cancer cells. It can be given orally or through an IV.
  • Radiation therapy: This treatment involves using high-energy radiation to kill cancer cells.
  • Bone marrow transplant: This treatment involves replacing the patient’s diseased bone marrow with healthy bone marrow from a donor.

Nursing Care for Multiple Myeloma Patients:

Nursing care for Multiple Myeloma patients involves a comprehensive approach to address their physical, emotional, and psychological needs. Here are some essential nursing interventions for Multiple Myeloma patients:

  • Pain management: Multiple Myeloma patients may experience bone pain, which can be managed with pain medications and non-pharmacological interventions such as massage, heat therapy, and acupuncture.
  • Infection prevention: Multiple Myeloma patients are at increased risk of infections due to weakened immune systems. Nurses must educate patients about infection prevention strategies, such as hand hygiene and avoiding sick individuals.
  • Nutrition support: Multiple Myeloma patients may experience a loss of appetite and weight loss. Nurses can work with a registered dietician to develop a nutrition plan that meets the patient’s needs.
  • Emotional support: Multiple Myeloma patients may experience anxiety, depression, and other emotional distress. Nurses must provide emotional support to help patients cope with the disease.

Multiple Myeloma Nursing Care Plan

Nursing Care Plan: Impaired Mobility

Nursing Diagnosis: Impaired mobility related to bone pain and skeletal complications as evidenced by patient’s limited range of motion, difficulty in ambulation, and expression of discomfort during movement.

Multiple Myeloma Nursing Interventions and Rationales:

  • Assess the patient’s level of pain and range of motion regularly (Rationale: To establish baseline data for monitoring progress and evaluating the effectiveness of interventions).
  • Administer prescribed analgesics as needed (Rationale: To provide pain relief and promote comfort).
  • Encourage the patient to change positions frequently and perform gentle range-of-motion exercises (Rationale: To promote circulation, prevent muscle atrophy, and maintain joint flexibility).
  • Provide assistive devices (e.g., walker, cane) as appropriate (Rationale: To enhance the patient’s ability to ambulate safely and independently).
  • Collaborate with a physical therapist to develop an individualized exercise plan (Rationale: To improve the patient’s strength and mobility while minimizing the risk of injury).

Desired Outcomes:

  • The patient will demonstrate improved mobility within their functional limitations.
  • The patient will report a decrease in pain and discomfort during movement.
  • The patient will maintain or increase their range of motion and muscle strength.

Nursing Care Plan: Risk for Infection

Nursing Diagnosis: Risk for infection related to immunosuppression and myeloma-induced immune dysfunction as evidenced by frequent infections, fever, and abnormal laboratory values (e.g., low white blood cell count).

Nursing Interventions and Rationales:

  • Monitor vital signs, particularly temperature, regularly (Rationale: To detect early signs of infection).
  • Assess the patient’s skin and mucous membranes for signs of infection (Rationale: Early detection of infection allows for prompt intervention).
  • Encourage proper hand hygiene for both patient and healthcare providers (Rationale: To minimize the risk of infection transmission).
  • Administer prophylactic antibiotics as prescribed (Rationale: To prevent the development of infections).
  • Teach the patient to avoid crowds and people with known infections (Rationale: To minimize exposure to potential sources of infection).

Desired Outcomes:

  • The patient will remain free from signs and symptoms of infection.
  • The patient will demonstrate an understanding of infection prevention measures.
  • The patient’s laboratory values will return to or maintain within normal limits.

Nursing Care Plan: Fatigue

Nursing Diagnosis: Fatigue related to anemia, pain, and the effects of cancer treatment as evidenced by the patient’s reports of lack of energy, inability to perform daily activities, and increased need for rest.

Nursing Interventions and Rationales:

  • Assess the patient’s level of fatigue regularly (Rationale: To establish baseline data for monitoring progress and evaluating the effectiveness of interventions).
  • Encourage the patient to prioritize activities and balance rest with activity (Rationale: To conserve energy and prevent excessive fatigue).
  • Provide a quiet, comfortable environment for rest
  • and sleep (Rationale: To promote restorative rest and minimize disturbances).
  • Collaborate with a nutritionist to develop a balanced diet plan, rich in iron and protein (Rationale: To address nutritional deficiencies that may contribute to fatigue).
  • Administer prescribed medications to treat anemia and manage symptoms as needed (Rationale: To improve the patient’s energy levels and overall quality of life).
  • Encourage the patient to engage in mild to moderate exercise, such as walking or yoga, as tolerated (Rationale: To improve overall physical condition and help combat fatigue).
  • Desired Outcomes:
  • The patient will report an improvement in energy levels and decreased fatigue.
  • The patient will maintain a balance between rest and activity.
  • The patient will demonstrate adherence to a balanced diet plan and prescribed medications.

What are the 2 main nursing concerns with Multiple Myeloma?

Multiple myeloma is a type of cancer that affects the plasma cells in the bone marrow. As a result, the two main nursing concerns with multiple myeloma are:

  1. Risk of infection: Multiple myeloma can weaken the immune system, making the patient more susceptible to infections. Nurses need to monitor for signs of infection and take precautions to prevent the spread of infection. This includes ensuring good hygiene practices, administering antibiotics as needed, and educating the patient and their family about the importance of infection prevention.
  2. Pain management: Multiple myeloma can cause bone pain, which can be severe and debilitating. Nurses need to assess and manage the patient’s pain, including administering pain medication and exploring non-pharmacological interventions such as relaxation techniques or physical therapy. They also need to monitor for side effects of pain medication and adjust the dosage as needed.

Frequently Asked Questions

Question 1. Is Multiple Myeloma curable?

A. There is currently no cure for Multiple Myeloma, but treatment can help manage the disease and improve the patient’s quality of life.

Question 2. How is Multiple Myeloma diagnosed?

A. Multiple Myeloma is diagnosed through a combination of physical exams, blood tests, imaging tests, and bone marrow biopsy.

Question 3. What is the life expectancy for Multiple Myeloma patients?

A. The life expectancy for Multiple Myeloma patients depends on several factors, including the stage of the disease, the patient’s age, and overall health. With early diagnosis and appropriate treatment, many patients can live for years with a good quality of life. However, the prognosis can be poor for patients with advanced stages of the disease or who have other health complications.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon


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This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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Anna Curran. RN, BSN, PHN

Anna Curran. RN-BC, BSN, PHN, CMSRN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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