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18 Cards in this Set

  • Front
  • Back
What syndromes increase the risk of cancer?
-Down syndrome increases risk for leukemia
- wiskott-aldrich syndrome increases risk for non-hodgkin's
- fanconi amenia increases risk for AML
- beckwith-weidemann syndrome increases risk for wilm's tumor
What are some common presenting symptoms of cancer?
anemia, pallor, bruising, petechiae, frank bleeding, wt. loss, anorexia, weakness, early satiety, infection, H/A, muscle weakness, incontinence, visual changes, visual or palpable mass, big increase in head circumference
What things would you assess initially in a child w/ cancer?
-F(x) of cancer
-personal history of increased risk disorder
-development & immunizations (no live vaccines, if due!)
-growth, nutrition, hydration, pain
-emotional state of parents
What are some things you should consider when a child is diagnosed w/ cancer?
(this is r/t psychosocial)
-be honest and realistic
-deal w/ today, today
- discuss whether to tell child and siblings, or not
- educate and empower family
- maintain routine and limit setting
- school is therapeutic
What general diagnostic tests are indicated w/ cancer?
-CBC: RBC: HGB, HCT, RBC indices (anemia)
-WBC- <500 is very low: increased risk for infection
-complete metabolic panel
-BUN/creatinine (before chemo)
-LFT (if jaundiced/suspect tumor there)
-alpha-fetoprotein-liver tumors
-VMA/HVA- adrenal tumors, neuroblastoma
- elevated catecholamines- neiroblastoma
What considerations might be taken for a child receiving a diagnostic test?
-Sedation for: MRI, CT, bone marrow, PICC (valium, fentanyl, chloral hydrate)
-Lidocaine, EMLA for lumbar puncture and intrathecal drug admin
What nursing considerations might be taken when talking to the child w/ cancer?
-Explain everything: what, how, discomfort, management of Side effects, importance of adherence to regimen

-Play therapy to express feelings/fears, clarify misconceptions, practice dolls

-emotional support
How long after a client begins receiving chemo will he/she begin to see the effects?
7-10 days!
What is G-CSF?
stimulates neutrophils
EX: neupogen:
-do not give w/in 48 hours of chemo
-CBC 2x/week
What is erythropoeitin?
stimulates erythrocyte production
EX: epogen, procrit
-s/e: fever, diarrhea, tisue swelling
What occurs in tumor lysis syndrome?
cancer cells break down and release potassium: watch out for HYPERKALEMIA!, purines released also: this causes hyperuricemia and allopurinol is needed to prevent uric acid production
-can quickly result in acute renal failure
What are interventions for tumor lysis syndrome?
-increased IV fluids 48 hr before chemo- much higher rates during chemo
- baseline and daily wts
- strict I/O & BP
-urinary alkalinization to increase pH to 7.0
What administrations do you want to avoid w/ chemo?
Nursing care for stomatitis
same as for adult EXCEPT!
anesthetizes throat and gag reflex
What considerations would you have re: rectal ulcers?
-no rectal temps/meds
-warm sitz bath
-meticulous cleaning of area
Nursing care for hemorrhagic cystitis
-increase maintence fluid greater than or equal to 1.5 times the fluid maintenance
-encourage frequent voiding
What care would you consider for a neutropenic child?
- meticulous IV cath care
- frequent V/S to assess for septic shock: often only sign will be fever.
- increased HR/RR
- decreased BP
- give ordered antibiotics in timely manner
What are side effects of radiation therapy?
BONE: asymmetrical bone growth, increased risk for fracures. scoliosis, kyphosis, spinal shortening

HORMONAL: hypothyriodism, hypopituitarism, growth (assess thyroid func. every 6 mo for 3 yrs), infertility, delayed secondary sex changes in girls

NERVOUS SYSTEM: lethargy, drowsiness, seizures, learning disorders, H/A, cataracts, change/loss of taste

OTHER: pneumonitis, pericardial fibrosis, GI malabsorption, decreased salivation, decreased tooth growth, nephritis, chronis cystitis, alopecia, mucositis, diarrhea