Child w/ malignancy (Ch 22) Flashcards

1
Q

which germ cell layer becomes connective tissue, muscle, bone, cartilage, kidneys, sex organs, blood, blood and lymph vessels and lymphoid organs

A

embryonic mesodermal germ layer

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2
Q

the embryonic mesodermal germ layer becomes?

A

connective tissue, muscle, bone, cartilage, kidneys, sex organs, blood, blood and lymph vessels and lymphoid organs

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3
Q

Most childhood cancers arise from which germ layer?

A

embryonic mesodermal germ layer

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4
Q

most adult cancers involve what type of tissue?

A

epithelial tissue

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5
Q

cancer of the epithelial tissue

A

carcinomas

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6
Q

carcinomas are cancers of which tissue type?

A

epithelial

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7
Q

In a majority of pediatric oncology cases, the tumor has metastasized at the time of diagnosis?

A

True

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8
Q

delayed diagnosis of cancer in children can be attributed to?

A
  • nonspecificity of symptoms

- provider lack of experience and knowledge

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9
Q

most common types of childhood cancer?

A
  • nonepithelial leukemia
  • lymphoma
  • sarcomas
  • embryonal
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10
Q

most common types of adult cancer?

A

epithelial carcinoma

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11
Q

some S/S of childhood cancer?

A
  • bone or abd pain
  • mediastinal mass
  • pale
  • lethargy
  • bruises easily
  • petechiae
  • weight loss
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12
Q

a small (1–2 mm) red or purple spot on the skin, caused by a minor bleed from broken capillary blood vessels

A

petechiae

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13
Q

the presence of pallor, ecchymoses and petechiae may indicate which type of cancer?

A

leukemia

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14
Q

Asymmetry of facial features may indicate which type of cancer?

A

retinoblastoma or nasopharyngeal rhabdomyosarcoma

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15
Q

enlarged, firm lymph nodes that are painful upon palpation and associated with weight loss, fever, and an abnormal chest x-ray may indicate which type of cancer?

A

a lymphoma such as Hodgkins lymphoma or NHL

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16
Q

What are the benefits of treating cancer by combining drugs that act different phases of the cell cycle?

A
  • optimizes cell destruction
  • reduces risk of developing a tolerance
  • allows for smaller doses, reducing the potential for side effects from each drug
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17
Q

common side effects of chemotherapy in children?

A
  • myelosuppression
  • N/V
  • diarrhea
  • hair loss
  • skin problems
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18
Q

suppression of bone marrow functions?

A

myelosuppression

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19
Q

Phases of chemo?

A

1) induction
2) consolidation
3) maintenance
4) observation

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20
Q

The phase of chemo where intensive therapy is given to kill enough cancerous cells to induce a remission?

A

induction

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21
Q

phase of chemo where remaining cancer cells are targeted?

A

consolidation

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22
Q

phase of chemo designated to provide less intensive txx to destroy any residual cancer cells?

A

maintenance

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23
Q

a child is consider to be a cancer survivor once they have been disease free for how long?

A

5 yrs

24
Q

the side effects of chemo and radiation therapy result primarily from the destruction of which type of cells?

A
  • rapidly dividing cells (mucous membranes, hair follicles and bone marrow)
25
Q

Acute A/E’s of radiation therapy usually occur?

A

7-10 days after the start of tx and can last weeks to months after completion of therapy

26
Q

general A/E’s of biotherapy?

A
  • flulike symptoms
  • fluid retention
  • low-grade fevers
  • bone pain
  • chills
  • rash
  • neuropathic pain
27
Q

Nursing interventions prior to initiation of biotherapy?

A
  • obtain baseline vitals

- preemptive meds against A/E’s

28
Q

abnormally low number of neutrophils?

A

neutropenia

29
Q

Causes of weight loss in children with cancer?

A
  • substances secreted by the tumor
  • pain
  • N/V
  • stomatitis
  • metabolic disturbances
  • alterations in taste
30
Q

Steroid use may cause?

A
  • increased appetite
  • weight gain
  • fluid retention
31
Q

Nutritional assessment of a child with cancer?

A
  • daily weights
  • I & O
  • calorie counting
  • labs (Na, K, albumin, Ca, Ma, glucose, protein)
32
Q

diet for child on steroids?

A
  • low Na (want to minimize fluid retention)

- low cal meals and snacks

33
Q

period after chemo during which the immune cell count is at its lowest point?

A

nadir

34
Q

nadir occurs how long after initiation of chemo?

A

7 - 10 days

35
Q

this drug stimulates the bone marrow to repopulate granulocytes more quickly and efficiently, decreasing the duraion of neutropenia

A

G-CSF

36
Q

Vaccines that can be administer to a child on chemo includes?

A
  • diptheria-tetatnus-pertussis
  • hep B
  • inactivated poliovirus
  • pneumococcal
  • influenza
37
Q

abnormally low platelet count?

A

thrombocytopenia

38
Q

abnormal proliferation of WBC’s?

A

leukemia

39
Q

What is the most common childhood cancer?

A

leukemia

40
Q

most common type of leukemia in children?

A

Acute Lymphocytic Leukemia (ALL)

41
Q

ALL originates/effects which type of cell?

A

B & T lymphoid cells (Blast cells)

42
Q

Pathophysiology of ALL

A

leukemic cells proliferate and pack the bone marrow, interfering with hematopoiesis

43
Q

ALL s/s?

A
  • anemia
  • neutropenia
  • thrombocytopenia
  • extramedullary disease
44
Q

Common sites of extramedullary spread from leukemia?

A

CNS, testes, liver, kidneys and spleen

45
Q

First diagnostic procedures needed for leukemia diagnosis?

A

CBC, lumbar puncture, bone marrow aspiration, and biopsy

46
Q

Sanctuary sites (hiding spots) for leukemia?

A
  • testes

- CSF

47
Q

Risk factors associated with Acute Myeloid Leukemia?

A

-radiation exposure in utero, maternal smoking during pregnancy, hx of previous malignancy, trisomy 21, environmental factors

48
Q

Low-grade tumor definition?

A

slow growing, contains a few mitotic cells, and show no evidence of necrosis or vascular proliferation

49
Q

High-grade tumor definition

A

rapid growing, contain multiple mitotic cells and show evidence of necrosis and endothelial and vascular proliferation

50
Q

tx of choice for children with a brain tumor?

A

surgical resection

51
Q

two major types of lymphoma?

A

Hodgkins and Non-Hodgkins

52
Q

Common organs affected by metastatic spread of lymphomas?

A

spleen, liver, bones, lungs and bone marrow

53
Q

S/S of Hodgkins Lymphoma?

A

painless, firm movable nodes

  • hepato and/or splenomegaly
  • anorexia
  • weight loss of > 10% within 6 months
  • malaise and lethargy
  • drenching night sweats
  • fever of > 3 days
54
Q

When possible, radiation therapy should be avoided until what age?

A

8 y/o

55
Q

Peak incidence of NHL?

A

7 - 11 y/o

56
Q

Wilms tumor affects which organ?

A

the kidney