A charge nurse is providing an in-service to a group of nurses about chronic myelogenous leukemia (CML). Which of the following should the nurse include in the teaching as risk factors for this condition? (Select all that apply)

Calculation:

• Convert the client's weight from pounds (lb) to kilograms (kg).

Weight in kg = 245 lb / 2.2 lb/kg

= 111.3636 kg.

• Calculate the desired dose per administration in milligrams (mg).

Desired dose per administration (mg) = Desired dose (mg/kg) × Weight (kg)

= 4 mg/kg × 111.3636 kg

= 445.4544 mg.

Available concentration of the medication = 250 mg / 5 mL.

• Calculate the volume in milliliters (mL) to administer per dose.

Volume (mL) = Desired dose per administration (mg) / (Available concentration (mg) / Available volume (mL))

= 445.4544 mg / (250 mg / 5 mL)

= 445.4544 mg / 50 mg/mL

= 8.909088 mL.

• Round the answer to the nearest tenth.

= 8.9 mL.

A. Being a white male: Although the incidence of CML may vary by gender and ethnicity, being a white male is not a specific or major risk factor for CML. CML can affect individuals of any race or gender.

B. Hormone therapy: Hormone therapy is not a primary risk factor for CML. While hormone therapies may increase the risk of other types of cancer like breast and prostate, they are not associated with the development of chronic myelogenous leukemia.

C. Chemotherapy: Previous chemotherapy treatment is a known risk factor for developing CML. Certain chemotherapy agents, especially alkylating agents, can cause DNA damage that leads to mutations associated with leukemia.

D. Under the age of 50 years old: CML is more common in adults over the age of 50, with the median age of diagnosis being around 60 years. Younger individuals, particularly those under 50, are less likely to develop CML, making age under 50 not a typical risk factor.

E. Radiation exposure: Exposure to ionizing radiation is a well-established risk factor for the development of CML. Individuals who have had significant radiation exposure, such as atomic bomb survivors or those who received radiation therapy, have an increased risk of developing leukemia.