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23 Cards in this Set
- Front
- Back
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COMMON CHILDHOOD CANCERS
•___ 30% •Brain tumors 22% •Neuroblastoma 7% •Wilms tumor 6% •Bone cancers: osteosarcoma/ewings sarcoma 3% •Hodgkins and non-hodgkins lymphoma •Rhabdomyosarcoma •Retinoblastoma |
Leukemia
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MEDICAL INTERVENTION
Chemotherapy Radiation Therapy Surgery Transplant -Stem Cell -Bone ___ |
Marrow
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COMMON CHEMOTHERAPEUTIC DRUGS
V___ C___ M___ D___ P___ D___ Can it be? Can it be ___ will E cayote went ___ Dexa, Doxo |
Vincristine
Cisplatin Methotrexate Dexamethasone Prednisone Doxorubicin |
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CHEMOTHERAPY EFFECTS
Early Effects: •Hair loss •Pain •Fatigue •___ pain •Paresthesias •Peripheral ___ |
Bone
neuropathy |
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CHEMOTHERAPY EFFECTS
Late Effects: •Bone pain •Peripheral neuropathy •___ loss •Ataxia •___ DTRs •Myopathy •Osteonecrosis •Osteoporosis |
Hearing
Decreased |
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RADIATION THERAPY EFFECTS
Early Effects: •Skin redness •Blistering •Hair loss •___ •Fatigue •Cognitive Deficits |
Fibrosis
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RADIATION THERAPY EFFECTS
Late Effects •Fibrosis •Pathologic ___ •Bone Growth Abnormalities •Osteonecrosis, osteoporosis •___ necrosis •Cardiac problems •Htn |
Fracture
Avascular |
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PHYSICAL THERAPY SYSTEMS REVIEW
Integumentary •Bruising; skin temp/color/texture Cardiovascular/ Pulmonary •Respiratory rate; heart rate, exertion, fatigue Neuromuscular •Pain •Sensation •Antalgic gait •Guarding •Muscle tone –increased or decreased •Paralysis •Cognitive deficit |
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SYSTEMS REVIEW
MUSCULOSKELETAL Range of Motion •Joint contracture or foot drop •Goniometry •Functional ROM Strength •MMT •Dynamometer •Functional ability --PEDI Postural alignment QOL •Pediatric Quality of Life Scale Developmental Skills •Standardized tests Locomotion/ Gait •Walking tests •TUG •Timed Up and Down Stairs Balance •Pediatric Balance Test |
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PHYSICAL THERAPY ASSESSMENT
•Impairments •Activity Limitation •Participation •Environmental/ Personal Factors •QOL |
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EXERCISE GUIDELINES
Monitor •Vital signs •Patient pallor •Fatigue level •Bruising •Petechiae •Patient report Be aware of •Medical Interventions –Lumbar puncture; bone marrow testing; chemo infusion |
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EXERCISE GUIDELINES
NO EXERCISE IF: •Platelet count < ___ •Hemoglobin < 8 •WBC < ___ |
< 20,000
< 5,000 |
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EXERCISE GUIDELINES
LIGHT EXERCISE IF: •Platelet count ___ •Hemoglobin ___ •WBC >5000 |
20,000-50,000
8-10 |
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EXERCISE GUIDELINES
RESISTIVE EXERCISE IF: •Platelet count > ___ •Hemoglobin >___ •WBC > 5000 |
> 50,000
>10 |
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EXERCISE GUIDELINES
NORMAL VALUES: •Platelets ___/ul •Hemoglobin ___ G/100 ml •WBC ___/mm |
•Platelets 150,000-350,000/ul
•Hemoglobin 10-13 G/100 ml •WBC 4500-11,000/mm |
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PATIENT
•3 y/o •Presenting symptoms = excessive bruising; antalgic gait •Diagnosed with ALL •Chemotherapy protocol: •Prednisone, Dexamethasone •Vincristine •Doxorubicin •Methotrexate •3 years |
PHYSICAL PERFORMANCE
•Parents report patient c/o of pain when walking; previously age appropriate motor skills •FACES scale: no pain at rest; 5 (>) with standing or assisted walking •Asks parent for assist with all transfers; content to sit in play; does not try to keep up with siblings •Note increased exertion with assisted transitions; note increased RR and paucity to perform |
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KNOWN RISKS OF RECENT CHEMOTHERAPY TREATMENT
Vincristine •___ pain •Weakness •Parasthesias •Peripheral neuropathy •___ dysfunction |
Leg
Motor |
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KNOWN RISKS OF RECENT CHEMOTHERAPY TREATMENT
Steroids •Osteonecrosis •Osteoporosis •___ muscle weakness •Growth ___ |
Proximal
suppression |
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KNOWN RISKS OF RECENT CHEMOTHERAPY TREATMENT
Doxorubicin •Bone marrow ___ •___ toxicity •Myocarditis |
suppression
Cardio |
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KNOWN RISKS OF RECENT CHEMOTHERAPY TREATMENT
Methotrexate •___ •Osteopenia •Osteoporosis •Bone fracture •___ deficits •Coordination impairments |
Arthralgia
Visual spatial |
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IMPAIRMENTS
•Weakness •Deconditioning •Pain Monitor for: •Peripheral neuropathy, osteonecrosis, fx, visual perceptual deficits, coordination impairment, SOB |
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ACTIVITY AND PARTICIPATION LIMITATIONS
•Unable to move comfortably without assistance from parent/ caregiver •Unable to play with siblings/ peers •Unable to locomote independently |
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PHYSICAL THERAPY PLAN OF CARE
•Goal –Patient will stand at table in play for 3 minutes without c/o of pain 2 out of 5 trials. •Activity –supported standing at chest height table •Motivation –stickers and paper; toys on table for play •Feedback –hands on with verbal feedback •Increase Challenge -? •Decrease Challenge -? |
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