Child w/ malignancy (Ch 22)

Question 1

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

Answer 1

embryonic mesodermal germ layer

Question 2

the embryonic mesodermal germ layer becomes?

Answer 2

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

Question 3

Most childhood cancers arise from which germ layer?

Answer 3

embryonic mesodermal germ layer

Question 4

most adult cancers involve what type of tissue?

Answer 4

epithelial tissue

Question 5

cancer of the epithelial tissue

Answer 5

carcinomas

Question 6

carcinomas are cancers of which tissue type?

Answer 6

epithelial

Question 7

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

Answer 7

True

Question 8

delayed diagnosis of cancer in children can be attributed to?

Answer 8

• nonspecificity of symptoms

- provider lack of experience and knowledge

Question 9

most common types of childhood cancer?

Answer 9

• nonepithelial leukemia
• lymphoma
• sarcomas
• embryonal

Question 10

most common types of adult cancer?

Answer 10

epithelial carcinoma

Question 11

some S/S of childhood cancer?

Answer 11

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

Question 12

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

Answer 12

petechiae

Question 13

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

Answer 13

leukemia

Question 14

Asymmetry of facial features may indicate which type of cancer?

Answer 14

retinoblastoma or nasopharyngeal rhabdomyosarcoma

Question 15

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?

Answer 15

a lymphoma such as Hodgkins lymphoma or NHL

Question 16

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

Answer 16

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

Question 17

common side effects of chemotherapy in children?

Answer 17

• myelosuppression
• N/V
• diarrhea
• hair loss
• skin problems

Question 18

suppression of bone marrow functions?

Answer 18

myelosuppression

Question 19

Phases of chemo?

Answer 19

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

Question 20

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

Answer 20

induction

Question 21

phase of chemo where remaining cancer cells are targeted?

Answer 21

consolidation

Question 22

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

Answer 22

maintenance

Question 23

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

Answer 23

5 yrs

Question 24

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

Answer 24

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

Question 25

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

Answer 25

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

Question 26

general A/E's of biotherapy?

Answer 26

- flulike symptoms - fluid retention - low-grade fevers - bone pain - chills - rash - neuropathic pain

Question 27

Nursing interventions prior to initiation of biotherapy?

Answer 27

- obtain baseline vitals | - preemptive meds against A/E's

Question 28

abnormally low number of neutrophils?

Answer 28

neutropenia

Question 29

Causes of weight loss in children with cancer?

Answer 29

- substances secreted by the tumor - pain - N/V - stomatitis - metabolic disturbances - alterations in taste

Question 30

Steroid use may cause?

Answer 30

- increased appetite - weight gain - fluid retention

Question 31

Nutritional assessment of a child with cancer?

Answer 31

- daily weights - I & O - calorie counting - labs (Na, K, albumin, Ca, Ma, glucose, protein)

Question 32

diet for child on steroids?

Answer 32

- low Na (want to minimize fluid retention) | - low cal meals and snacks

Question 33

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

Answer 33

nadir

Question 34

nadir occurs how long after initiation of chemo?

Answer 34

7 - 10 days

Question 35

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

Answer 35

G-CSF

Question 36

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

Answer 36

- diptheria-tetatnus-pertussis - hep B - inactivated poliovirus - pneumococcal - influenza

Question 37

abnormally low platelet count?

Answer 37

thrombocytopenia

Question 38

abnormal proliferation of WBC's?

Answer 38

leukemia

Question 39

What is the most common childhood cancer?

Answer 39

leukemia

Question 40

most common type of leukemia in children?

Answer 40

Acute Lymphocytic Leukemia (ALL)

Question 41

ALL originates/effects which type of cell?

Answer 41

B & T lymphoid cells (Blast cells)

Question 42

Pathophysiology of ALL

Answer 42

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

Question 43

ALL s/s?

Answer 43

- anemia - neutropenia - thrombocytopenia - extramedullary disease

Question 44

Common sites of extramedullary spread from leukemia?

Answer 44

CNS, testes, liver, kidneys and spleen

Question 45

First diagnostic procedures needed for leukemia diagnosis?

Answer 45

CBC, lumbar puncture, bone marrow aspiration, and biopsy

Question 46

Sanctuary sites (hiding spots) for leukemia?

Answer 46

- testes | - CSF

Question 47

Risk factors associated with Acute Myeloid Leukemia?

Answer 47

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

Question 48

Low-grade tumor definition?

Answer 48

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

Question 49

High-grade tumor definition

Answer 49

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

Question 50

tx of choice for children with a brain tumor?

Answer 50

surgical resection

Question 51

two major types of lymphoma?

Answer 51

Hodgkins and Non-Hodgkins

Question 52

Common organs affected by metastatic spread of lymphomas?

Answer 52

spleen, liver, bones, lungs and bone marrow

Question 53

S/S of Hodgkins Lymphoma?

Answer 53

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

Question 54

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

Answer 54

8 y/o

Question 55

Peak incidence of NHL?

Answer 55

7 - 11 y/o

Question 56

Wilms tumor affects which organ?

Answer 56

the kidney