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25 Cards in this Set

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Cardinal S/S of childhood cancer

-Fever s infection


-Persistent headache


-Fatigue / malaise


-Anorexia / unintentional weight loss


-Lymphadenopathy


-Pain


-Abdominal mass


-Extremity mass

Cardinal S/S of childhood cancer

-Purpura, petechiae, or bruising


-Pallor


-Changes in gait, balance, or personality


-Limping


-Night sweats


-Pancytopenia


-Hematuria

History

-Weight loss


-Bone pain


-Incidence & frequency of fevers


-Recurrent infections


-Fatigue


-Bleeding

Diagnostics

-Labs


-Bone marrow analysis: suspected hematologic malignancies


-Tissue biopsy: suspected lymphomas & solid tumors


-X-rays


-CT scan


-MRI


-PET scan

Surgery: indications

-Diagnostic biopsy: confirmation


-Staging


-Debulking or partial resection


-Complete resection


-Debridement of necrotic tissue


-Relief of mechanical obstruction


-Symptom palliation by reduction of tumor burden without cure

Chemotherapy

-Kills cells that divide rapidly


-Effects: bone marrow, GI tract, hair follicles

Radiation

-Target tumor for destruction while sparing surrounding tissues


-Side effect: erythema or skin irritation

Gene therapy

-Focus on changing / altering genetic code of tumor cell

Biotherapy

-Interferons


-Interleukin-2


-Retinoids


-Monoclonal antibodies

Hematopoetic Growth Factors

-Stimulate growth of neutrophils & RBCs

Neutropenia: precautions

-Filtered bath & drinking water

-Hepa filter for room


-No fresh flowers


-Strict hand hygiene


-Visitors & staff screened for resp. infection

Absolute Neutrophil Count (ANC)

= (% segs + % bands) x total WBCs

= (segs + bands) x WBCs x 10


<500

Body Surface Area (BSA)

SQR* (ht [cm] x wt [kg]) / 3600*

Thrombocytopenia: precautions

-No rectal temps, probes, or meds

-No NGT insertion, injections, or accessing port unless OK'd


-No finger sticks unless OK'd



Typhlitis (neutropenic enterocolitis)

-Cancer emergency


-Invasion into bowel mucosa in neutropenic pt

Pancreatitis

-Cancer emergency


-Drug associated: L-asparaginase


-Vomiting, ABD pain, L-asparaginase admin

Tumor Lysis Syndrome

-Cancer emergency


-Increased risk: expect rapid response to tx


-First 12-24h after chemo


-Rapid lysis of tumor cells


-Release massive quantities of intracellular contents into systemic circulation (K+, Phosphate, nucleic acids)


-Prevention: aggressive IV hydration

TLS: manifestations

-N/V/D


-Anorexia


-Lethargy


-Hematuria


-Heart failure


-Arrhythmias


-Seizures


-Muscle cramps, tetany


-Syncope -> sudden death

Leukemia: manifestations

-Fever


-Malaise


-Pallor


-Bruising


-Bone / joint pain


-High WBCs


-Hepatosplenomegaly

Leukemia: nursing care

-Signs of infection & bleeding: skin & mucosa


-Central line dressing changes


-Report fever 101.3 once or 100.4 over 1h

Brain tumor: manifestations

-Headache


-Morning vomiting

Brain tumor: history

-Developmental milestones


-School performance


-Vision changes / loss

Brain tumor: potential deficits

-Gait


-Extremity strength & movement


-Speech & language


-Swallowing


-Vision & hearing


-Seizure potential

Osteosarcoma

-Initial signs = sports injury or growing pains


-Most often during adolescent growth spurt


-Tibia, humerus, femur

Wilms tumor

-Renal tumor: one or both


-Asymptomatic, mobile ABD mass


-Must not be palpated: risk of rupture & spread of cancer cells


-Remove tumor & kidney