Chapter 24: Oncology Lecture Review Flashcards
What are common diagnostic tests used for childhood cancer and nursing responsibilities for each?
CT/MRI/PET/MRA: Explain procedure, assess for allergies (contrast), provide sedation if needed, monitor post-op vitals.
Lumbar Puncture: Position the child, monitor for headache or CSF leak afterward.
Bone Marrow Aspiration/Biopsy: Provide emotional support, monitor for bleeding/infection post-procedure.
Blood tests (CBC, electrolytes, LDH): Ensure correct labeling, gentle venipuncture technique.
What are general cancer symptoms in children?
Pain, cachexia, anemia, infections, bruising/petechiae, neurologic symptoms, palpable mass.
What is the pathophysiology of leukemia?
Abnormal WBCs rapidly proliferate in bone marrow, crowding out RBCs and platelets; the immature WBCs can’t function, increasing infection risk.
What are signs and symptoms of leukemia?
Fever (61%), bleeding/petechiae (48%), bone pain, pallor, fatigue, splenomegaly (63%), hepatomegaly (68%).
How is leukemia diagnosed?
CBC, bone marrow aspiration (looking for lymphoblasts), lumbar puncture.
How is leukemia treated?
Chemotherapy (4 phases: induction, consolidation, delayed intensification, maintenance), radiation for CNS/testicular involvement, stem cell transplant if needed.
What is the prognosis for ALL?
5-year survival ~85%. Worse if WBC > 50,000 at diagnosis.
How long does treatment last?
> 2 years for girls; >3 years for boys.
What are expected lab values at diagnosis for leukemia?
Low Hgb, Hct, Platelets; WBC can be high, low, or normal but often abnormal in function.
What are common symptoms of brain tumors?
Morning headaches, N/V, gait abnormalities, vision changes, fatigue.
How are brain tumors diagnosed?
CT, MRI, PET, MRA, lumbar puncture.
How are brain tumors treated?
Surgery (debulk/remove), radiation (esp. medulloblastoma, ependymoma), low-dose chemo (limited due to blood-brain barrier).
What are complications of brain tumor treatment?
Seizures, infection, hydrocephalus, growth delay, impaired cognition/behavior.
What post-op neuro and vital sign changes are concerning?
Increased sleepiness, bradycardia, low RR, high BP—may signal ICP or brain herniation.
What is Wilms tumor and when does it occur?
Intrarenal tumor, usually before age 5; often linked to congenital syndromes (e.g., Beckwith-Wiedemann).
What are symptoms of Wilms tumor?
Usually painless abdominal mass (off midline), occasionally hypertension; hematuria and pain are rare.
How is Wilms tumor diagnosed?
Ultrasound first; CT of chest, abdomen, brain for staging; CBC, BUN/Cr, electrolytes.
What are complications after treatment for Wilms tumor?
Liver damage (esp. R-sided tumors), radiation injury to pelvis/thorax, glomerular damage to remaining kidney.
What are key nursing concerns for Wilms tumor?
DO NOT palpate abdomen—can rupture tumor. Monitor kidney function. Educate parents on gentle handling.
Who gets osteosarcoma and where?
Adolescents during rapid growth (13–17 years), often in distal femur, proximal tibia, or humerus.
What are symptoms of osteosarcoma?
Pain (esp. at night), swelling, limp, referred hip/back pain.
How is osteosarcoma diagnosed?
X-ray (may show “sunburst” sign), bone scan, CT/MRI, LDH.
What is the treatment and complications of osteosarcoma?
Limb salvage or amputation + chemo. Complications include lung metastasis, phantom limb pain, infection.
What are psychosocial considerations for osteosarcoma?
Body image, coping with amputation, long-term disability, peer interactions.
