Oncologic (moderate priority, 5-7 questions)

Question 1

Leukemia

Answer 1

#1 type of cancer in kids
Causes: bone pain, anemia, bleeding disorders, lymphadenopathy, immunosuppression

Question 2

Acute Lymphoid Leukemia (ALL)

Answer 2

most common type
Peak age 2-5 years old
> 85% cure rate
death after overwhelming infection

Question 3

Acute Myelogenous Leukemia (AML)

Answer 3

more common than ALL in adolescents
60-70% cure rate
death after overwhelming infection

Question 4

Brain tumor s/s

Answer 4

• headache upon awakening (most common symptom)
• vomiting
• seizures
• abnormalities in coordination, gait, reflexes, speech

Question 5

Toddler view of death?

Answer 5

no concept of time or space

* fear is related to separation from parents

Question 6

Preschooler view of death?

Answer 6

• seen as temporary departure, as in sleep

- May fear separation from parents

Question 7

School-age view of death?

Answer 7

• understands death’s permanence & causality
• fears pain & abandonment
• is curious about own death

Question 8

Adolescent view of death?

Answer 8

• past experiences play a role in understanding & coping
• may express anger
• may want to plan own funeral

Question 9

Lymphomas

Answer 9

Hodgkin’s – painless enlargement of lymph nodes
Non-Hodgkins - swelling in abdomen or neck; congestion/URI symptoms

Systemic symptoms - weight loss; fever, night sweats

Question 10

Wilms’ Tumor (Nephroblastoma)

Answer 10

• avg age 2-4 yo
• tumor is unilateral
• assess for nontender mass, midline near liver
• s/s: abdominal pain, HTN, hematuria, anemia or constipation

DO NOT PALPATE ABDOMEN: may disseminate cancer cells to other sites

• loose clothing near abdomen
• tx is nephrectomy w/in 24-48 hours of dx followed by chemotherapy

Question 11

Tumor Lysis Syndrome

Answer 11

• serious metabolic disorder occurring w/in 72 hours after starting chemotherapy
• -> increased uric acid, potassium & electrolyte management

Intervention: Electrolyte/Fluid Management

• restrict K+ intake, fluid administration
• diuretic
• strict I & O
• daily weights