Childhood Cancer Flashcards
(50 cards)
- Bone Marrow Aspiration/Biopsy
Used to diagnose leukemia
- Nursing Responsibilities: Pain management, emotional support, sterile technique, monitoring for bleeding.
Lumbar Puncture
Checks for cancer cells in cerebrospinal fluid.
- Nursing Responsibilities: Positioning, sedation (if needed), monitoring for headache or bleeding.
CT, MRI, PET scans
Imaging for solid tumors.
- Nursing Responsibilities: IV contrast preparation, ensuring the child remains still (possible sedation).
Diagnostic Tests
Bone Marrow Aspiration
Lumbar Puncture
CT/MRI/PET
CBC w/differential
CBC w/Differential
Evaluates WBCs, RBCs, and platelets.
= Nursing Responsibilities: Monitor for infection, anemia, bleeding tendencies
Leukemia Types
- Most common childhood cancer
Types: Acute Lymphoblastic Leukemia (ALL) (most common) &
Acute Myelogenous Leukemia (AML).
Peak onset 2 to 3 years
Leukemia S/S
- Fever
- Petechiae, bruising, bleeding (low platelets)
- Fatigue, pallor (anemia)
- Bone pain (leukemic cell infiltration)
- Hepatosplenomegaly
- Frequent infections
Leukemia Diagnosis
- CBC: High WBC (>50,000 = worse prognosis), low RBCs, low platelets.
- Bone marrow biopsy: >25% blast cells.
- Lumbar puncture: Check for CNS involvement.
Leukemia Treatment
Chemotherapy in four phases:
1. Induction (goal = remission)
2. Consolidation
3. Delayed Intensification
4. Maintenance (2-3 years)
CNS prophylaxis: Intrathecal chemotherapy to prevent brain involvement.
Stem cell transplant (in high-risk cases).
Supportive care: Blood transfusions, infection control, anti-nausea meds.
Leukemia Complications
- Neutropenia → risk of infection
- Tumor Lysis Syndrome
- Bleeding due to thrombocytopenia
- Long-term effects: Secondary cancers, learning disabilities, endocrine issues
Leukemia Prognosis
- ALL survival rate = ~85%
- Worse prognosis if: WBC >50K, age <1 or >10, CNS involvement, T-cell leukemia.
Relapse rate 20%
Brain Tumors
- Second most common pediatric cancer.
- Most common types: Medulloblastoma, Astrocytoma, Ependymoma.
Brain Tumor S/S
- Morning headaches
- Nausea/vomiting
- Vision changes (blurred, double vision)
- Balance issues, dizziness
- Fatigue, seizures
Brain Tumor Diagnosis
- MRI/CT
- Lumbar puncture (if no increased ICP)
- Biopsy if accessible.
Brain Tumor Treatment
- Surgery: Goal is tumor removal.
- Radiation: Used in children >3 years.
- Chemotherapy: For younger children or in combination with surgery/radiation
Brain Tumor Post Op Complications
- Signs of increased ICP: Decreasing LOC, bradycardia, hypertension (Cushing’s Triad).
- Diabetes Insipidus: Excessive urination, dehydration.
- SIADH: Fluid retention, hyponatremia.
Wilms Tumor (Nephroblastoma)
- Kidney tumor, usually unilateral.
- Peak age: 2-3 years
High association with Beckwith/Wiedmann syndrome
Wilms Tumor (Nephroblastoma) S/S
- Painless abdominal mass (DO NOT PALPATE!) asymptomatic one side of midline
- Hypertension
- Hematuria (rare)
- Abdominal pain (uncommon)
Wilma Tumor (Nephroblastoma) - Diagnosis
- Abdominal ultrasound, CT/MRI.
- Lab tests: CBC, renal function (BUN/Creatinine).
Wilma Tumor (Nephroblastoma) - Treatment
- Nephrectomy (removal of affected kidney).
- Chemotherapy ± radiation.
Wilma Tumor (Nephroblastoma) - Complications
- Hypertension (from renin secretion).
- Metastasis to lungs (check for respiratory symptoms).
- Long-term renal function concerns
Osteosarcoma
- Bone cancer, often in long bones (femur, tibia, humerus).
- Peak age: Adolescence (13-17 years).
Osteosarcoma S/S
- Bone pain (worse at night)
- Limping
- Swelling at tumor site
- Pathologic fractures (rare)
High risk for lung metastasis 20%
Osteosarcoma Diagnosis
- X-ray (“sunburst” pattern).
- Bone biopsy.
- MRI, CT to check for metastases
