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Peds Exam 3A > Childhood Cancer > Flashcards

Childhood Cancer Flashcards

1
Q

Retinoblastoma

A

congenital malignant tumor, arises from embryonic retinal cells
if 1 child has it siblings probably do too

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2
Q

diagnosis of retinoblastoma

A 
no red reflex
cats eye reflex is most common sign (think of what cat eyes look like when you shine a light in them)
strabismus- second most common sign
red, painful eye, often with glaucoma
blindness late sign
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3
Q

treatment of retinoblastoma

A

based on stage and time of dx
early- irradiation and cryotherapy to preserve vision in affected eye
bilateral disease- attempt to preserve useful vision in least affected eye
advanced tumor- enucleation
chemotherapy
chemotherapy- some controversy

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4
Q

prognosis of retinoblastoma

A

99% survival rate
tumor may spontaneously regress
concern with development of secondary tumors especially osteogenic sarcoma

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5
Q

complications of retinoblastoma

A

spread to brain and opposite eye
metastasis to lymph nodes, bone, bone marrow, and liver
secondary tumors, most often sarcomas, occurring in children who have been tx for retinoblastomas

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6
Q

post op care of retinoblastomas

A

large pressure dressing
dressing changes
sibling eye exams every 1-3 months for the first year

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7
Q

rhabdomyosarcoma

A

highly malignant cells in muscle, tendon, bursa, fascia and fibrous connective tissue, lymphatic, or vascular tissue

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8
Q

potential sites of rhabdomyosarcoma

A

head, neck, GU, extremities

symptoms may be vague and hard to dx

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9
Q

rhabdomyosarcoma treatment

A

highly malignant and frequent metastasis
complete removal of tumor if possible
radiation therapy for most
chemo to shrink may proceed with radiation
long term chemo 1-2 years

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10
Q

rhabdomyosarcoma prognosis

A

excellent in stage 1

poor if metastasis present during diagnosis

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11
Q

Hodgkins

A

more prevalent in 15-19 yo
neoplastic disease originating in lymphoid system
often metastasizes to spleen, liver, bone marrow, lungs and other tissues

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12
Q

how do you know its hodgkins?

A

presence of reed Sternberg cells

malignant B lymphocytes grow in lymph tissue

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13
Q

etiology of hodgkins

A

unknown but has been linked to Epstein Barr virus

need lymph node bx to diagnose

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14
Q

s/s of hodgkins

A

painless enlarged lymph nodes, fever, night sweats

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15
Q

treatment of hodgkins

A

radiation

chemotherapy alone or with radiation

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16
Q

prognosis of hodgkins

A

depends on stage, tumor bulk, classification

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17
Q

why should hodgkins kids not drink alcohol?

A

significant pain in effected nodes after consumption

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18
Q

complications for hodgkins

A

liver failure, secondary cancers, delayed puberty

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19
Q

can kids younger than 2 receive radiation?

A

no

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20
Q

signs and symptoms of brain tumors are

A

related to anatomic location, size, and child’s age

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21
Q

diagnostic testing to confirm a brain tumor

A 
MRI
CT
EEG
LP
histologic diagnosis via surgery
22
Q

presenting symptoms of a brain tumor

A

headache, vomiting, clusiness, unsteady gate, blurred vision, head tilt, seizures, moor abnormality, weakness, behavioral or personality changes, FTT, irritability, vital sign disturbances

23
Q

Therapeutic management of brain tumors

A 
depends on type of tumor
surgery
radiotherapy after the age of 2
chemo
prognosis
24
Q

postop care of brain tumors

A

positioning- tissue can shift in brain after tumor removal be mindful of this. child should remain midline, flat until they are able to sit. Children are usually sedated for a few days afterwards.
if child is sedated make sure eyes are hydrated
reduce ICP
neck flexion
NPO
comfort measures

25
Q

neuroblastoma

A

most common malignant extracranial solid tumor of childhood and infancy
develops in adrenal gland or retroperitoneal sympathetic chain (head, neck, chest, pelvis)

26
Q

diagnosis of neuroblastoma

A 
dx the younger the better
radiology studies
bone marrow
IVP to determine renal involvement 
Metastasis may have already occurred before diagnoses
27
Q

therapeutic management of neuroblastoma

A

clinical staging to establish treatment plan
surgery to remove tumor and obtain bx
radiation to shrink tumor for removal
chemotherapy
bone marrow transplant or stem cell rescue

28
Q

Typical CBC of a leukemia kid

A

low RBC, HgB, Platelets
High WBC
Blasts high

29
Q

consequences of leukemia

A

anemia from decreased RBC
infection from neutropenia
bleeding tendencies from decreased platelet count
spleen, liver, and lymph glands show marked infiltration, enlargement and fibrosis

30
Q

presenting symptoms of leukemia

A 
fever
pallor
bleeding
lethargy
malaise
anorexia
large joint and bone pain
31
Q

Cardinal signs of bone marrow failure

A

petechiae
frank bleeding
joint/bone pain
fatigue

32
Q

what does ANT stand for in leukemia

A

Anemia- low HgB
neutropenia- risk of infections
thrombocytopenia- bleeding

33
Q

how do you confirm the diagnosis of leukemia

A

bone marrow bx

bone marrow will show immature cells

34
Q

therapeutic management of leukemia

A

treatment for presenting symptoms
combination chemotherapy
cranial irradiation in some areas

35
Q

Ewing sarcoma

A

malignant bone tumor
arises from marrow especially in femur, tibia, ulna, humerus, vertebrae, pelvis, scapula, ribs, skull
high malignancy rate

36
Q

sign and symptoms of Ewing sarcoma

A

swelling and erythema at site. more likely o experience systemic symptoms (fever, spinal cord compression, respiratory distress)

37
Q

treatment of ewing sarcoma

A

radiation commonly first approach

chemotherapy as adjunct to radiation

38
Q

osteosarcoma

A

most frequent bone tumor in children
peak age of incidence 15 years
most primary tumor sites are in the metaphysis of long bones, especially legs
can occur is distal femus, humerus, tibia, pelvis, jaw

39
Q

signs and symptoms of osteosarcoma

A

pain
limp
decreased ROM

40
Q

complications of osteosarcoma

A

metastasis to lungs or other bones

recurrence within 3 years

41
Q

therapeutic management of osteosarcoma

A

traditional approach- radical surgical resection or amputation of affected area
limb-salvage procedures- resection of bone with prosthetic replacement of affected area
chemotherapy accompanying surgical treatment

42
Q

nursing considerations for osteosarcoma

A

body image in adolescents
support during concepts of amputation, surgical resection
pain management
phantom limb pain

43
Q

nursing care of child with cancer

A

side effects of treatment managed
treatment complications prevented
child and family coping skills supports
quality of life
help child and family adjust to chronic illness
growth and development maintained during treament

44
Q

remission induced chemotherapy

A

rapid induction of complete remission, lasts 3-4 weeks, oral, steroids and IV chemotherapy

45
Q

consolidation (CNS prophylaxis)

A

strengthen remission

introduce CNS prophylaxis, intrathecal and IV administration

46
Q

intensification

A

destroy remaining or resistant cells

47
Q

maintenance

A

prevent relapse, treat metastasis

48
Q

signs of CNS involvement

A 
headache
persistent nausea or vomiting
irritability
dizziness
seizures 
behavior and personality changes
6th cranial nerve palsy, abductus- lateral eye movement
49
Q

what to know about chemo

A

it kills healthy cells too

50
Q

short term side effects of chemo

A 
immunosuppression
infection
myelosuppression
nausea
vomiting
oral mucositis
alopecia
51
Q

long term side effects of chemo

A

microdonita and missing teeth
hearing and vision changes
hematopoietic
immunologic or gonadal dysfunction
endocrine dysfunction
various alterations of the cardiorespiratory, GI, GU
development of secondary cancer as an adolescent or adult

Peds Exam 3A (5 decks)

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