Families Exam 5 - neoplastic Flashcards
Where does the malignancy occur with Wilm’s tumor?
in the kidneys or abdomen
What are signs of metastasis with Wilm’s tumor?
- dyspnea
- SOB
- cough
- chest pain
What does the mass feel like with Wilm’s tumor?
- painless
- firm
- nontender
What is important to monitor after surgical removal of Wilm’s tumor?
- GI/GU function
- infection
What might be needed pre-op for Wilm’s tumor?
chemo/radiation
What labs are done for Wilm’s tumor?
- BUN/creatinine
- CBC
- urinalysis
- abd ultrasound
- abd/chest CT
- inferior venacavogram
- bone marrow aspiration
Where is a neuroblastoma found?
- adrenal gland
- neck
- chest
- pelvis
- sympathetic chain of the retroperitoneal area
Why are neuroblastomas called “silent tumors”?
only 1/2 of children are symptomatic
What treatment is done for a neuroblastoma?
- surgical resection
- chemo/radiation
What labs are done for a neuroblastoma?
- CBC, coagulation studies
- urine catecholamines
- skeletal survey
- skull/neck/chest/abdominal/bone CT
- bone marrow aspiration
- metaiodobenzylguanidine scan
- biopsy
What are early signs of leukemia?
- low grade fever
- pallor
- bruising, petechiae
- enlarged liver, lymph nodes, joints
What are late signs of leukemia?
- pain
- hematuria
- mouth ulcers
- enlarged kidneys and testicles
- increased ICP
What is the most definitive diagnosis for leukemia?
bone marrow aspiration or biopsy analysis
How is CSF analyzed for leukemia?
lumbar puncture
Anemia (erythrocytopenia) can occur with Leukemia and chemotherapy. What are signs of this?
- drowsy/fatigue
- SOB/ decreased oxygenation
Thrombocytopenia can occur with Leukemia and chemotherapy. What are signs of this?
bleeding, bruising
Neutropenia can occur with Leukemia and leukocytopenia can occur with chemotherapy. What are signs of this?
infection
When should chemotherapy be administered?
early in the day
What should be given before chemotherapy?
antiemetics
When is ondansetron contraindicated with chemotherapy?
with long QT syndrome
Why is filgrastim given for chemotherapy?
it stimulates neutrophil production in the bone marrow
When might bone pain, splenomegaly, and leukocytosis be seen?
when taking filgrastim
What is pancytopenia and when does it occur?
- destruction of all blood cells
- chemotherpay
What should be done if a patient experiences mouth ulcers from chemotherapy?
- frequent oral care
- soft toothbrush
- lip balm
- soft, bland foods
- mouth wash
- local anesthetics
What should be avoided if the patient experiences mouth ulcers from chemotherapy?
- lemon glycerine swabs
- lidocaine
- hot/spicy foods
How can infection be prevented with chemotherapy?
- good hygiene
- avoid sick people and crowds
- take temp everyday
What type of meals should a patient doing chemotherapy eat?
small, frequent, well-balanced
What do nurses have to wear when caring for a patient undergoing radiation?
a lead apron
What should be monitored at the radiation site?
skin integrity
What should you avoid using at the radiation site?
- creams
- lotions
- soaps
- powders
- petroleum jelly
Why would a patient undergoing radiation need to wear loose long sleeves and a hat?
they need to protect their skin from the sun
Why should the skin of a patient undergoing radiation be washed using your hands and lukewarm water and then patted dry?
to avoid washing off marks on the skin that outline targeted areas
