Cancer Flashcards
1
Q
define leukocytosis
A
- WBC > 10,000
- usually indicates infection, inflammation, tissue necrosis, or leukemic neoplasia
2
Q
define leukopenia
A
- WBC <4,000
- occurs in many forms of bone marrow failure
3
Q
how to determine the absolute neutrophil count (ANC)
A
- tells us the ability to fight infection
- first add the total percentage of “neutrophils”–“polys” or “segs” or “bands”
- then change that total percent to a decimal and multiply by the total # of WBCs
- so if WBC is 2000, and there are 10% neutrophils and 7% bands, then we have 17% (0.17) total neutrophils
- 0.17*2000=340
- if ANC is <500, then the pt is at risk for:
- infection (sepsis)
- general malaise
- dehydration
- seizures (young infants and children)
- invasion of organisms producing secondary infections
- we would put these clients in protective isolation–limit visitors, tell them to avoid crowds
4
Q
leukemia
A
- S/S: child growing and thriving, then all the sudden dec in status
- anemia, dec WBC, dec plt, bone/joint pain, thinning/weakening of bones, hepatosplenomegaly, LN involvement, petechiae/bruising
- confirm dx by:
- bone marrow biopsy: wear a mask, sterile procedure, go into big bone in hip, monitor O2 sats
- CBC with diff
- LP: allows us to see if leukemia has infiltrated the CNS
- tx: chemo and radiation
- SEs: alopecia (teach that hair may grow back different than pre illness), bone pain, diarrhea, dry skin, ulceration of mucosa
- tx protocol is individualized based on the pt’s numbers
5
Q
what is complete remission determined by?
A
- absence of clinical S/S
- <5% blast cells in the bone marrow
6
Q
chemo drugs
A
- these meds destroy cells
- have to use a cocktail of drugs inorder to attach the cells at different stages
- ie. vincristine: neurotoxic–>can develop foot drop
- ie. corticosteroids
7
Q
tumor lysis syndrome
A
- destruction of lots of tumor cells leads to electrolyte problems
- hyperuricemia
- hypocalcemia
- hyperphosphatemia
- hyperkalemia
- uremia
- the crystallization of uric acid in the renal tubules can lead to acute renal failure and death
8
Q
tx of tumor lysis syndrome
A
- early identification of pts at risk
- serum chemistry and urine pH frequently
- strict I & O
- aggressive IV fluids
- meds:
- allopurinol–dec uric acid production and promote excretion of by products of purine metabolism
9
Q
complications of cancer
A
- tumor lysis syndrome
- anemia
- thrombocytopenia
- leukopenia and infection
- pain
10
Q
Wilm’s tumor (nephroblastoma)
A
- malignant tumors of the kidney
- most often affects young children
- can be u/l or b/l
- possible genetic inheritance
- autosomal dominant
- also assoc with other congenital anomalies
- aniridia: absence of the iris in the eye
- hemihypertrophy and GU anomalies
11
Q
clinical manifestations of Wilms’ tumor
A
- hallmark sign: abdominal swelling
- painless swelling or mass w/in tumor
- hematuria
- anemia
- HTN: tumor in kidney so affecting renin release
- weight loss
- fever
- metastasis to lungs–>dyspnea, cough, SOB, and pain in the chest
12
Q
diagnostics with Wilms’ tumor
A
- x ray: abdominal u/s
- MRI, CT scan
- bone marrow aspirate: looking for infiltrates
- hematological studies
- urinalysis
13
Q
what would be tx therapy if Wilms’ tumor was u/l?
A
- take out the kidney with the tumor!
14
Q
preop care for a child with wilms’ tumor–palpation of abdomen
A
- place sign over bed: “Do not palpate abdomen”–>can rupture tumor and spreads tumor cells
- also keep child from falling and rupturing
- S/S of rupture:
- pain: acute and localized in abdomen
- hemorrhage:
- cardiac: inc HR, widening PP, pallor
- abdomen: acute localization of pain, distention, guarding tummy area
- neuro: changes in LOC, irritability, restlessness, disorientation
15
Q
preop care for Wilms’ tumor
A
- take care in bathing and handling of child
- obtain necessary blood work
- monitor BP
- use appropriate BP cuff
- monitor urine output
- daily weight
- assess child for HTN:
- bounding pulses
- inc irritability and HAs
- changes in behavior
- flushing
