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106 Cards in this Set
- Front
- Back
Define Anemia
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reduction in the number of RBC &/or Hgb
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Name the most common hematologic disorder in infancy and childhood
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Anemia
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List three main causes for Anemia
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Inadequate RBC Prod, Increased RBC Prod, Excessive Loss RBC
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S/S of Decreased Production of RBC
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Pallor, Tachycardia, Fatigue, Muscle Weakness, Systolic Murmur
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S/S of Increased Destruction of RBC
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Jaundice, Tachycardia, Dark Urine, Splenomegaly, Hepatomegaly, Low BP (late sign of shock), Frontal bossing
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S/S of Inc RBC Loss
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Pallor, Fatigue, Muscles weakness, Cool Skin, Tachycardia, Decrease Peripheral Pulse
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This is the most prevalent nutritional disorder in US
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Iron deficiency
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If a baby is premature how long with Iron Store last
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No Iron Store build up available
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Full term infants Iron Store will last how long
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5-6 months
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Preterm or multiple birth babies will have an Iron Store lasting how many months
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2-3 months
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What is the primary therapeutic management goal
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Prevention
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What is a good way to get IRON in to the diet if they are 4 to 6 mo of age
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Iron fortified formula, cereal
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Define Retic
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immature Red Blood Cell
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Ferrous Sulfate by another name is
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Iron Supplement
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Common Side Effects of Iron Supplement
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Nausea, GI Irritation, Diarrhea, Constipation
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An Acidity Aid is given to help with Iron absorption what specific kind of food or beverage should the supplement be given with
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Citrus Food or Juice
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What is the color of the stool of an individual that is taking iron supplements
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tarry green or black
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With Sickle Cell which part of the Hgb is defective
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Globin in Hgb
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Sickle Cell is a has a multi system impact, List other systems & organs impacted
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Spleen, Liver, Gallbaddler, Kidney’s, Bones, Cardiac, CNS,
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What is Dactylitis
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Inflammation of the digits
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Explain Sequestration Crisis
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Pooling of large a quantities of blood, usually spleen
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True or False 70% of individuals with sickle cell will experience repeat strokes
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True without Transfusions
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A Electrophoresis can help determine and diagnosis what two types of Sickle Cell
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Trait & Disease
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Things the Nurse will due to manage a PT with Sickle Cell
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IV Fluids, PCA Narcotics, Transfusion of Blood, Oxygen for hypoxia
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Explain Chelation Therapy related to Sickle Cell
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Removes Iron Overload with transfusion bind to remove iron from blood.
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Excessive destruction of platelets
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Idiopathic Thromboyctopenia Purpura (ITP)
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ITP is Acute or Chronic
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ITP can be both
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S/S of ITP
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Bruising, petichiae, bleeding
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When DX ITP what two disease processes are you trying to rule out
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Lupus & Leukemia
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Chronic ITP TX is
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Spleenectomy
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With a Spleenectomy Ibuprofen is preferred over Tylenol, True or False
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False Tylenol is preferred
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Secondary disorder of coagulation, Characterized by bleeding and clotting simultaneously is
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Disseminated Intravascular Coagulation (DIC)
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Sepsis, Injury, Hypoxia/LTE, Shock States are all common trigger for what bleeding and clotting disorder
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Disseminated Intravascular Coagulation (DIC),
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Telling sign of DIC is Accelerated clotting, ______________, tissue ischemia, _______________& limbs
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Micro clotting in vessels, Loss of organ function
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True or False with DIC if supportive TX is successful function will return to limb or organ?
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True
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In CPR what do the three C’s Stand for
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Compressions Compressions Compressions
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Rate of _______ compressions per minute
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100
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If a team is involved in CPR how often should you rotate compressions?
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2-3 Minutes
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AEDS are acceptable for children great than _____ years of age?
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> or = to 1 year of age
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Name the Cancer with the Highest Survival Rate
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Hodgkin’s Lymphoma & Non Hodgkin’s Lymphoma 94%
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These three types of Cancer have the highest incidence, what are they
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Leukemia, Brain & Spinal Cord & Neuroblastoma
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To DX childhood cancer the following steps will be taken
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Complete History, ROS, Physical, Lab Test, Imagining, Biopsy
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List Multimodal Therapy that might be used to treat childhood cancer
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Surgery, Radiation, Chemo, BMT (bone marrow transplant), Genetics (stem cell), Vaccines (HPV)
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Monocolonal Antibodies & G-CSF as well as GM-CSF & Interleukin 1-6 are all what types of treatment
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Biotherapy
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What is the primary purpose of G-CSF (Neupogen) Biotherapy treatment
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To increase WEB production of Neutrophils as to decrease the risk for infection
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True or False the National Cancer Institute plans and initiates comparative clinical trials, Prevention, Treatment, Long term effects & investigational drugs related to cancer?
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True
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How many Phases are included in the Investigational Drug Trial process
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3 Phases
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Phase 1 of the Investigational Drug Trail
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Assess the maximum does tolerated
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Phase 2 of the Investigational Drug Trail
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Assess tumors reaction to the drug
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Phase 3 of Investigational Drug Trail
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Looks at most effective routs, length of TX & combinations of drugs
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List cardinal signs of cancer
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Unusual mass or swelling
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List cardinal signs of cancer
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Unusual mass or swelling, Paleness & loss of energy, Bruising, Pain or limping, Fever, HA w Vomiting, Vision Changes,Excessive or rapid wt loss
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Cellular destruction from infiltration of immature cells and competition for metabolic elements is also known as
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Leukemia
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The type of cancer is more common in Preschool Age children
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Acute Lymphocyctic Leukemia (ALL)
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Adolescents generally have this type of cancer usually related to a genetic disorder
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Acute Myelogenous Leukemia (AML)
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Which cancer is less responsive to Chemo AML or ALL
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AML Acute Myelogenous Leukemia
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Characteristics of AML
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10 Yrs or Older, More CNS & organ involvement at DX
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First Treatment for AML is usually
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BMT (Bone Marrow Transplant)
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ALL is Acute lymphocytic Leukemia which has a good or poor prognosis
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GOOD
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True or False ALL is very responsive to chemotherapy?
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True
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What type of cell is involved in AML
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Myeloblasts
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Name cells involved in ALL
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B Cells, T Cells, Pre T Cell, Early Pre B Cells
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Is CALLA a Good Prognostic Indicator True or False
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True
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B Cell usually results in a Good or Poor Prognosis
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Poor
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Pre B Cell usually results in a Good or Poor Prognosis
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Good
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T Cell usually results in a Good, Fair or Poor Prognosis
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Fair
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Immature white blood cell production decreased all of these BM, Hypermetablism, Reticuloendotheial except
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CNS Increased ICP
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Bone Marrow Depression Resulting in the 3 following things, Neutropenia (inc infection), Decreased RBC (inc Anemia) &
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Thromboyctopenia (increased bleeding)
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With Leukemia which Lab value is generally normal or increased, while all other Labs such as RBC’s, Plts, Neutrophils, Hemoglobin are all decreased
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WBC count
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How do they DX for Leukemia
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BM, Lumbar Puncture, CBC, Live & Renal Function Study
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What is the location of the BM draw
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Iliac Crest
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Allopurinol (Zyloprim) is to treat what that common occurs with Chemo & Radiation Tx
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Uric Acid
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What is the rescue drug for Methotrexate
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Leukovorin
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What is the Function of G-CSF
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Increase Neutrophil Count to “STIMULATE BM”
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What do these meds have in common Vincristine, L-Asparaginase
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IV Route
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ALL is usually treated with Prednisone what is a common S/E (hint steroids)
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Increased Blood Glucose Level
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This drug can result in neurotoxicity, such as foot drop & illeus
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Vincristine
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With the 1st round of Chemo a decrease of __% of blast should occur to have a positive prognosis and remission
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5%
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A Nurse must calculate and draw Epi when giving what drug
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L-Asparaginase
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When monitoring the Temp on a PT with Leukemia the best result comes from an Axillary or Rectal Temperature
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NO Rectal
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What is the #1 way to protect a PT with Altered Immunity
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GOOD HAND WASHING!!!!
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A PT with an altered immunity can have a banana and orange just no strawberries
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True Anything with peel .
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List a positive side effect of Prednisone for Cancer PT
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Increase Appetite
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Post irradiation Somnolence is a result of what
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Neurotoxicity
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Hodgkin’s Disease has a _____ Prognosis for Adolescents and Young Adults
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Good
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Tx for Hodgkin’s is
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Radiation, Chemo, Body Image and Reproduction
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DX of Hodgkin’s with Biopsy, ______ & _____?
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Lymphangiogram, Staging
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Non-Hodgkin’s impact the CNS & BM, True or False
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True
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A BM aspiration is used to DX Non-Hodgkin’s
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True
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TX for Non Hodgkin’s is
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Irradiation & Chemo
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True or False more tumors in children are in the Supratentorial area (lower brain stem)
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False , Infratentorial
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Optic Brain Tumor in a child
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Optic Glioma
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Childhood Cancer in the Medulla
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Medullablastoma
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S/S of Brain Tumors
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Ataxia, HA, Motor Weakness, Vomiting, Visual Defect, Cranial Enlargement, Papilla Edema, SZ
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A PT has returned to PAC, what Post –Op care should you the Nurse be checking
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Neuro LOC, ICP, Pupil Check, Head Circ, SZ, Fluid Balance, Position
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The Silent Tumor is known as the
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Neuroblast
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Common site for Neuroblast are
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Abd, Neck, Head, Chest , Pelvis
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When a Neuroblast is present an individual PT will see an increase in Adrenal
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Catecholamine
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Increased Catecholamine’s will also increase what vital sign
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BP
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Neuroblast are often Dx at what Stage
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Stage 3 & 4
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A 24hour UA is used to DX Neuroblastoma, increased levels of what should be present
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Catecholamine’s
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DX Neuroblastoma Scans, _____, Renal Function & 24 hour UA
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Liver Function Test
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Define Aniridia
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No Iris
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S/S of Neuroblastoma
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ABD Mass, Bone Mets, Spinal Cord Paralysis, Wt loss, Weakness,
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If a child Dx with Neuroblastoma has an increased FE level is this a good or bad marker for prognosis
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BAD
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Neurblastoma prognosis is poor
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2 year survival rate and 5%
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