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76 Cards in this Set
- Front
- Back
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Why does the presentation of cancer dismissed?
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Because s/s are like that of developmental growth.
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What are the common presenting symptoms of cancer?
ABC - MIN! |
Anemia
Bleeding Cachexia (muscle wasting) Mass Infection Neuro problems |
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What neurological symptoms are seen with brain tumors and spinal tumors?
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Brain- early morning vomiting
Sprinal-incontinence |
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A child is recently diagnosed with cancer. He asks the nurse if he is going to die, what is the best response by the RN?
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Don't lie. Can tell them you don't know.
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What type of communication is needed for children with cancer?
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realistic, and honest
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What are common diagnotic labs preformed for a child with cancer?
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- CBC with differential (with closely monitoring RBC, WBC PLATELETS & ANC).
- Complete Metabolic panel - Renal - Liver - Urinalysis |
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This diagnostic test identifies, classifies and stages cancer. It is usually the definitive procedure for diagnosis.
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biopsy
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Thsi diagnostic test is painful and is completed on the sternum and iliac crest. This test is used for the diagnosis and monitoring of effectiveness of the therapy/treatement of the cancer.
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bone marrow aspiration
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A side effect of Chemo is bone marrow suppression. How many days does it take for suppression after chemo is started?
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5-7 days
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This medication is given to stimulate granulocyte production?
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Neupogen
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Neupogen is given to stimulate WBC production. The RN knows that if the ANS is greater than this number, Neupogen will be discontinued.
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10,000
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A child is recieving Neupogen and is going to start Chemo in a few days. The RN knows to withhold Neupogen how much hours before the start of chemotherapy?
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48 hrs.
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This medication is given to increase production of erythrocytes.
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Epogen or Procrit
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With the administeration of Epogen or Neupogen, what should be monitor for an increase in this?
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BP
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What four generalized problems can occur with children receiving chemo?
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N/V, malnutrition, constipation/diarrhea, and increased RF infections.
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What four specific problem can occur with a child receiving chemo?
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1. stomatitis
2. rectal ulcers 3. hemorrhagic cystitis 4. alopecia |
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A child in on chemo and currectly has stomatitis r/t chemo treatments. What nursing care is provided for this child?
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Soft tooth brush, mouth care before/after meals, normal saline or plain water for mouth rinsing.
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A child is on chemo and has stomatitis. This is never given to little children in the risk of loosing their gag reflex temporary.
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Lidocaine
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A child in on chemo treatments and has currently developed rectal ulcers. As the RN, what can we do for this pt? What is not performed on this pt?
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warm sitz bath and meticulous cleaning of the area; rectal temps or meds
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What is Alopecia?
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loss of hair
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A child has developed Hemorrhagic cysitis with his chemo and radiation treatments. As the RN, what realized the normal maintance rate of fluid will be increase this much more.
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1.5 times
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What three things are NEVER given to children on Chemotherapy?
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- ASA or NSAIDS
- LIVE VACCINES - FOLIC ACID |
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A child is neuropenic. What two subtle changes are early signs of impeding shock?
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increased HR and decreased BP.
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What type of tempatures are taken in a neutropenic child?
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oral or axillary
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What pets are not good for a child on chemotherapy?
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birds and reptiles
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What type of diet is good for a child on chemotherapy?
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high protein, high caloric
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With a thrombocytopenic child, a decreased platelet count of this puts the pt at risk for spontanous bleeding?
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10,000
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With a thrombocytopenic children, we watch for this in the stool, urine and gums.
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bleeding
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What types of activities can be done to decrease fear of radiation therapy for a child?
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-tour the department, dry run
-use child friendly facility -picture and have them talk to other children who have done it |
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During radiation therapy, children have skin markings for radiation sites. As the nurse what do we not to do?
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rub them off
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What are some immediate side effects of radiation therapy?
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-extreme fatigue
-increase risk for fractures -anorexia, N/V |
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Normally antiemetics are not given until the age of 2. But it is okay to administer a child on this an antiemetic.
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radiation
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In this disease, there is an overproduction in white blood cells. What type of WBC are seen?
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Leukemia; immature blast cells
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Leukemia symptoms stem from bone marrow suppression, WBC can be greater than this and ANC less then this.
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100,000 and 500
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Leukemia symptoms there is an increase risk for bleeding and brusing. It is common for Platelets to less than this.
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100,000
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What is a normal WBC count?
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5 -10,000
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This is the definitive test for leukemia?
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bone marrow aspiration
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This test is completed to see if the leukemia is present in the pt spinal fluid?
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Lumbar puncture
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This type of leukemia is 75% curable. It is more often seen in 2-5 y/o white boys. A increased RF is if the mother had an XRAY or radiation was done during pregnancy. This type also has immature lymphocytes.
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ALL -acute lymphoid leukomia
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This type of leukemia is curable in 50% of older children and is present in immature myelocytes (spinal cord cells).
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AML - acute myelogenous leukemia
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This type of management for leukomia is only done on high risk pt and for proven CNC involvement. Normally not done on children less than 3 y/o.
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Cranial irradiation
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This managment of leukemia is completed because the pt is unable to get into remission. Indications are induction failures (over 1,000 WBC), relapses within one year of completion of therapy and high risk presentation.
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BMT (bone marrow transplant)
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The nurse know to avoid which portion of the abdominal assessment.
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palpation
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An opaque ratina is associated in with pediatric tumor?
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retinoblastoma
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Which virus is associated with Hogekin's Disease?
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Epstein Barr virus (monno)
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What are the three symptoms for a brain tumor?
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-H/A upron rising
-Early morning vomiting (unrelated to feelings) |
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What type of nursing care problems can be seen with brain tumors?
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neuro problems
gait problems BP problems |
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This is the second most common neurological malignant tumor and it is found in the spine and adrenal gland. It has a median age of 22 months and is rare after 10 years. Orginated in the nerve tissue.
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Neuroblastoma
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What symptoms are seen in Neuroblastoma?
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1. Pain
2. firm, non tender, irreg crossing the medline abdominal mass 3. Cerebral mass with ecchymosis, periorbital edema, exophthalmos 4. Dx of tumor or bone marrow and catechoamines in the urine. |
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What does radiation do for neuroblastoma?
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-shrinks the tumor for removal in sx
-used for spinal cord compression -palliative care for bone, brain matastases. |
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The important thing to remember with neuroblastoma is the ____ the better the prognosis.
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younger
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This is the third common malignant tumor and it is a lymph system malignancy.
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Lymphoma
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This type of lymphoma is since in 5-15 y/o with previous EBV (monno) infection or a sibling with this disease. Lymph nodes are closer to the surface.
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hodgkin's disease
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This type of lymphoma is seen prior to pubety and B-cell and T-cell lymphomas are present with nodes more deep.
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Non hodgkin's disease
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What type of cells are the marker for Hodgkin's Disease?
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reed sternberg cells
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What three diagnostic test is completed for Hodgkin's disease?
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Ct and gallium and bone scan
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Which disease are you more likely to see painless lymph node enlargement.
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Hodgkin's Disease
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This lymphoma has solid tumors of the lymph system. They diffuse, rather than nodular and b-cell and t-cell mutations. It aggressively spreads and Needs CBS prophylaxis.
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Non hodgkin's disease
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This is a malignany of the skeletal muscle (bone, cartilage or fate is where it is found).
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Rhabdomyosarcoma
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What are the common sites for Rhabdomyosarcoma??
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Head and neck
GU tract Orbit of the eye |
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What is the maternal risk factors of Rhabdomyosarcoma?
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maijuana, cocaine use and XRAY exposure.
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This test is completed for metastatsis in Rhabdomyosarcoma? this one is to isolate the tumor?
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bone marrow aspiration; radiographic
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This type of cancer is located in the retina and the main symptom is called "cat" eye?
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Retinablastoma
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What is the leading characteristic in Retinablastoma? whereas this is normally the first sign for the parent.
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fixed strabismus; one eye is red and one is white in a picture.
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What type of exam is completed in Retinablastoma?
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opthalmological
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What is the sequence of care for a enucleation?
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-irrigation then antibiotic to socket
-daily eye patch change -soak in soapy warm water -eye protection over good eye |
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This type of tumor has a mass on one side of the kidney. cancer is incapsuled in the tumor.
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Wilm's Tumor
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What is no done to a pt with Wilm's tumor?
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no palpation
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There is an excess of this in Wilm's tumor?
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rinan
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What malifestations are seen with Wilm's tumor?
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-firm, non tender, confined one side
-anemia -pallor, wt loss - hematuria, HTN |
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What three diagnostic testing is completed in Wilm's tumor?
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1. US
2. chest/abdominal CT 3.Urinalysis |
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A pt is was dx with Wilm's tumor and is post op nephrectomy. He begins have flank pain on the non op side. What is occurring?
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problems with the good kidney
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Post nephrectomy with dx of Wilm's tumor, what issue can occur?
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Decreased U/O
Increased BP flank pain non op side pulmonary complications unexplained wt gain |
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This type of bone tumor metaphysis of the bones with symptoms of pain, limping pain and mass. There is an increased risk with hx of hereditary retinoblastoma.
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osteosarcoma
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This type of tumor is seen in the dyaphysis (middle) of the long bones. Symptoms are pain, mass and fractures.
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Ewing's Sarcoma
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This diagnostic lab is normally high in growing children but is high with the presence of cancer in the fully grown.
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serum alkaline phosphatase
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