Cancer Book Flashcards
** look at table 24-1, understand the different tests for childhood cancer. what are the nursing responsibilities for each
biopsy: pain
bone marrow aspiration: pain, anxitey
CT/CAT: anxiety/allergies to contrast
lumbar puncture: pain, anxiety
MRI: anxiety, implants
PET/SPECT: anxiety
XR: anxiety
nuclear: anxiety
ultrasound: anxitey
lab: pain, blood, anxiety
** lukemia s/s, onset, underlying path, how is it dx’d, how is it treated, complications, long term prognosis for ALL, what findings at time of diagnosis indicate a worse prognosis
s/s: fever, pallor, over s/s of bleeding, anorexia, petechiae, frank bleeding
onset: peak 2-3 ALL, <2 or adol AML
underlying path: chromosomal predisoption, radiation, chemo, occurs when bone marrow produce immature WBC which fill the marrow
dx’d: blood counts (anemia, thrombocytopenia, neutropenia) and bone marrow aspiration
complications: realpse
long term prognosis for ALL: high, less sequealla than AML
worse prognosis: initial WBC, higher then WBC worse prognosis
** lukemia treatment duration
2-3 years
- longer than adults
** leukemia what lab values do you anticipate
high WBC, low platelets, low hbg
** brain tumors: s/s, onset, underlying pathology, how is it dx’d, how is it treated, complications
s/s: behavioral or neural = HA, N/V, abnormal gait, dizziness, change in vision or hearing
onset: all the way until 19
patho: usually occur below roof od cerebellum and involve the cerebellum, mid brain, and brain stem
dx? CT/MRI/PET/SPECT
treated: depends on type, surgery ration chemo
complicaitons: severe infections, seizures, sensiormotor defect, hydrocephalus, and growth problems
** when you look at post op complications what are you looking for. what changes in neuro exam and vital signs
s/s of increased ICP and infection
- tachycardia, irregular resp
s/s of seizures and DI
DI = low blood pressure and increase output
** wilms tumor
what are the s/s
asymptomatic, firm, lobulated to one side of the midline in the abdomen, hypertension, hematuria, abdominal pain
**wilms tumor dx
ultrasound
** wilms tumor complications with the mass and after treatment
w mass: hypertension, bleeding, spread of cancer
tx: liver damage, portal hypertension, mild cirrhosis, kyphosis, socloiosis, glomular damage, 2nd malignancies
** wilms tumor what are some important nursing considerations
don’t palpate the mass
**osteosarcoma, what age of onset is common
what physical findings might the patient present with
peak indigence is during rapid growth years: G 12, B 13
pain, swelling, limp
- pain may be referred to hip or back
** osteosarcoma how is it treatmed , complications of treatment, how might complications arise, how would we treat them
chemo/surgery = amputaiton or salvage
salvage is removal of tumor and place bone graft
** osteosarcoma what major psychosocial considerations are there
body apperence due to ampuation
**lymphoma and non Hodgkin lymphoma who is at risk and what is the etiology
NHD: geographic, decrease immune, viral infection. malignant tumors of lymphoreticular origin
HD: genetics, viral infection, enviornmental. lymphoid system
** retinoblastoma how does this present, what is the treatment
first sign is a white pupil (leukokoria, or cats eye reflect) fixed strabismus, glaucoma, heterchomia
removal of the eye, cryotherapy, photocoagulation, radiation, chemo (sometimes)
**know all oncologic emergencies and how they are treated
- most common
tumor lysis, septic shock, bone marrow suppression, GI and CNS bleeding, DIC
** why is febrile neutropenia an emeegrncy
possible infection and patient has now neutrophils so not able to fight off infection
** what is hyperleukocytosis and how is this related to prognosis
increased production of WBC
higher WBC = worse prognosis
** what lab values are you going to see for tumor lysis syndrome? who is the highest risk for TLS?
hypo cal, hyperkal, hyper uric, hyperphos
increase risk with high tumor burden (big tumor =big risk
** what are some discharge considerations and home teaching
education: adequate nutritional intake, s/s of infection, decrease exposure to illness, admin meds, N/V
if a port: clean, install heparin
be as normal as possible, play, cancer support group, view child as normal
process of stem cell transplant
administer a Letha dose of chemo and radition that will kill cancer cells and then resupply with donor cells
what are the most commonly occurring solid tumors
brain
risk factor for Brian tumor
radiation
neuroblastoma
solid tumor occurring outside of cranium
when is wilms tumor often discovered
during a bath
treatment of wilms
removal of affected kidney
most common tumor of the skeletom
osteosarcoma
what kind of metastasis occurs with osteosarcoma
lung
cardinal signs of marrow failure
petechiae
frank bleeding
joint pain
electrolytes during leukemia
increase uric acid, pot, phos
decrease cal
chemo stage
- indiuction
max cell death
chemo stage
- consolidation
certain type of chemo
chemo stage
- delayed intensification
additional drugs to kill cells that have survival
chemo stage
- mainentence
destroy remaining cells
Hodgkin s/s
contender, firm, lymphadenopathy
- reed Sternberg cells
non HD s/s
fever
wt loss
enlarged/nodular lymph glands
intraocular malignancy of retina
retinoblastoma
s/s of retinoblastoma
white pupil is first sign
red reflex is absent
fixed stabismus
ortibial inflammation
glaucoma
heterchomia
treatment of retinoblastoma
removal of the eye
