Cancer Flashcards
Cancer
The leading cause of disease related death in children
Overall survival rate 84%
Secondary cancers
Stress of chemo
Family Stress
Long term effects ( can affect growth and development )
Cancer (causes, S/SX, Dx )
Causes: genetic mutations, immune system, chromosomal defects
S/SX: Pain, cachexia ( not wanting to eat ), anemia, infection, bruising (PLT not right), neurologic, palpable mass
DX: BIOPSY ( only way to definitively diagnose ), CBC, Lumbar puncture, MRI, CT, US, PET ( see if cancer metastasize )
Cancer ( TX, and adverse effects )
TX: chemotherapy, radiation (use for local tumor ), surgery (can cut it out), biotherapy (uses body own defense ), stem cell or bone marrow transplant
Adverse effects: bone marrow suppression, infection risk r/t decreased WBC (FILGRASTIM), decreased RBC (EPOETIN), decreased PLT (OPRELVEKIN), or transfusions, nausea (ODANSTERONE), weight loss , mucositis (sores in mouth, painful ) - to help biotene mouth wash, constipation (POLYETHYLENE GLYCOL ), alopecia, body image, pain (OPIOIDS, NSAIDS )
Neutropenic Precautions
- Low - microbial diet ( no raw fish, cheese, eggs, undercooked meat, if its not pasteurized they cant have it )
- No fresh fruits or veggies
- Wash hands and good hygiene
- Oral care
- avoiding live vaccine
- Avoiding crowds
- No fresh flowers/plants
- prophylactic antibiotics
Tumor Lysis Syndrome (patho, s/sx, tx )
Patho: Dissolving or decomposing tumor
- High serum uric acid, hyperkalemia, hypocalcemia, hyponatremia
- Seen with lymphomas and ALL (acute lymphocytic leukemia )
S/SX: metabolic acidosis, cardiac dysrhythmias, renal failure
TX: ALLOPURINOL (to decrease uric acid), IV fluids to flush system, monitor labs
Brain Tumors (Causes, S/SX, TX, Nursing )
Causes: results from other cancer, treatments, or idiopathic
S/SX: behavioral and neurologic changes ( N/V, vision/hearing changes, balance issues )
TX: Surgery, radiation (>5 years old ), chemo (will give right into CSF)
Nursing: infection risk, growth and development problems , can lead to: Arginine Vasopressin Deficiency ( diabetes insipidus )
Neuroblastoma (patho, s/sx, nursing )
Patho: most common solid tumor outside cranium but follows the path of sympathetic nervous system
- prognosis depends on stage and age of child
S/SX: smooth, hard, nontender mass along sympathetic nervous system ( lump in chest / abdomen, bone pain, bruising around the eyes )
- weigth loss, and distention, fatigue, fever, irritability, bone pain
Nursing: can metastasize to lymph nodes –> bones, symtoms depends on tumor location, catch it before age 1 the better
Wilims Tumor (Neuroblastoma)
( patho, S/SX, TX, Nursing )
Patho + S/SX: asymptomatic firm mass to one side of abdomen / back ( grows rapidly ), hypertension
TX: Kidney sparing surgery, chemo/radiation
Nursing: monitor I/O, DONT PALPATE THE ABDOMEN - light touch ( can make the tumor burst open–> metastasize )
Osteosarcoma
Patho: Skeletal tumor (distal femur most common )
Cause: associated with radiation
S/SX: unilateral pain, swelling, limp, fractures
TX: surgery and chemo
Nursing: can metastasize to lung, kidneys, and brain
Ewing Sarcoma (less common)
(Patho, S/SX, TX)
Patho: small round cell tumor in bone shaft
- seen in: pelvis, ribs, shoulder blades, legs, and arms
S/SX: Fractures, pain, swelling
TX: surgery, chemo, radiation
Leukemia (patho, S/SX, DX, TX, )
Patho: the WBC are immature, they dont make it to the adult stage –> bone produces too many WBC. MOST COMMON CHILDHOOD CANCER
S/SX: infection that wont go away, anemia (decrease RBC), bleeding (decreased PLT )
DX: bone marrow biopsy - blast cells (immature WBC), lumbar puncture (can invade CNS), CBC (increased WBC, decreased RBC + PLT)
TX: chemo - 4 phases, bone marrow transplant, GVHD ( rash, increased liver enzymes )
Lymphoma ( Hodgkin and Non- Hodgkin )
( patho, s/sx, dx, tx )
Patho: cancer in the lymph nodes
- Adolescents highest incidence
S/SX: nontender, firm lymph node (NOT GOOD), fever, night sweats, weight loss
DX: Lymph node biopsy ( Reed Sternberg cells )
TX: chemotherapy
Rhabdomyosarcoma (patho, s/sx, nursing, tx )
Patho: soft tissue sarcoma (most common)
S/SX: symptoms depends on location - eye (strabismus ), GU tract (hematuria)
Nursing: difficult to dx, metastasis common
TX: surgery and chemo
