Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PEDS Unit 3 > Oncological Disorders: PT2 > Flashcards

Oncological Disorders: PT2 Flashcards

1
Q

What is an Osteosarcoma and what are the key items to keep in mind regarding it?

A
  • Tumor arises from bone forming cells
  • Occurs in long bones, often femur
  • Often diagnosed when child fractures the bone
  • X-ray - Sunburst appearance
  • Peak age: 15-16 yrs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some clues in a pt hx that may point to Osteosarcoma?

A
  • Pain in bones for a few months
  • Thought it was growing pains
  • Change of gate, etc
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is a Ewing’s Sarcoma and where does it commonly occur?

A
  • Bone tumor that arises in the marrow spaces of the bone or soft tissue around the bone
  • Commonly occurs in the femur, tibia or spine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the Codman Triangle?

A
  • It is a periosteal reaction
  • triangular area of new subperiosteal bone that is created when the tumor, raises the periosteum away from the bone.
  • Its surface manifestation is swelling in the effected area
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is a Rhabdomyosarcoma and where does it occur?

A
  • It is a tumor in a muscle
  • It can grow anywhere in the body, but it’s most common in the
    • Arms and legs
    • Head and neck
    • Urinary and reproductive organs
    • and even the EYE
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the key points to keep in mind re: Rhabdomyosarcoma?

A
  • Most often found in teenagers
  • S/S: soft or hard “lump” in muscle that doesn’t move
    • may move as a whole, but doesn’t “squish” like a typical muscle injury
  • Poor prognosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the Medical Treatment for Rhabdomyocarcoma?

A
  • Chemo
  • Radiation
  • Resection or Amputation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How does the medical team assist the family with deciding between limb saving or amputate procedures?

A
  • Med team may make recommendation based on case, but otherwise
  • We present data and numbers and support the family in making the choice
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

If amputation is going to occur, what post op condition do we need to prepare our pt for?

A
  • Phantom pain syndrome
  • Its real, it’s a neuro reaction and its treatable
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

If a patient is being treated for muscle or bone cancer and is compliaining of SOB, what could be the problem?

A
  • The cancer has matastasized in the lungs
  • SOB is the first sign of this
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a Retinoblastoma?

A
  • intraocular malignancy of the retina only found in children
  • It can be unilateral or both
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the s/s of retinoblastoma?

A
  • Leukoria (cat’s eye)
    • a whitish glow in the pupil
  • Strabismus
    • lazy eye
  • Eye pain
  • Blindness (late sign)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Why is it hard to pick up on visual changes with kids?

A
  • Kids won’t say they’re not seeing well out of one eye, for them they just can’t see well.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the Medical treatment for retinoblastoma?

A
  • Chemo
  • Can be used in combination with
    • Photocoagulation
    • Cryotherapy
    • Radiation
    • Enucleation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is retinoblastoma treated w/ photocoagulation?

A

Laser to destroy the retinal blood vessels that are feeding the tumor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is retinoblastoma treated w/ cryotherapy?

A

Freeze the tumor to destroy vessels which will stop growth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is retinoblastoma treated w/ enucleation and what do we keep in mind with it?

A
  • Enucleation is eye removal
    • shouldn’t keep the eye in if vision can’t be salvaged
  • Kids tend to roll with it, but it can be traumatizing for parents, will go through grieving process
  • Kids learn to accommodate (get used to the challenges of one eye) rather easily
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How do we support parents of kids going through enucleation?

A
  • Help them get used to seeing it and caring for it Educate how to monitor incision
  • Educate that kid will wear an eyepatch for a week or so and then, after healed, will get artificial eye
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the goal of chemotherapy?

A

Kill malignant cells, prevent metastasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a metastsis?

A

the development of secondary malignant growths at a distance from a primary site of cancer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

True or False

Chemo goes through the body and will affect ANY cell that is rapidly reproducing regardless if it is the target cell or not.

A

True

22
Q

What are some examples of non-cancerous cells that are affected by chemo?

A
  • hair folicles rapidly grow, thus why peeps lose their hair
  • FX mucous membranes and blood producing cells in marrow so they’ll have less RBC, Platelets, WBCs and be more @risk for infection, bleeding and fatigue
23
Q

Chemo dosage, method of admin, and length of tx will be determined by…

A

its effect on the pt’s body

24
Q

True or False

All registered nurses can admin chemo.

A

False, only certified RNs can

25
Q

What are items we need to keep in mind re: admin of chemo?

A
  • Need to know how to take care of yourself and pt
  • Special gloves worn, all mats used are thrown away in special radioactive bags and desposed w/ toxic waste
  • Chemo is peed out about 48 hrs after chemo treatment, so have to take safety precautions at home for radioactive pee.
  • Diapers will go in that med waste - the special gloves are used for changing diapers or emptying a pee bin, etc
  • If staff or family is pregnant, they don’t take care of the patient at all
26
Q

What two methods are used for central line access for chemo?

A
  • Broviac
    • w/ external tube hanging
    • more maintenance and behavior mod
      • no swimming, showering, etc
  • Portocath
    • Internal
    • No maintenance/behavioral mods
    • Just the puncture pain during admin/access
27
Q

What are three areas have common complications to chemo?

A
  • Hair
  • GI
  • GU
28
Q

What is the chemo complication for hair and how do we address it?

A
  • Alopecia
    • loss of hair
  • Need to consider psychosocial impact
  • Support and Educate that it will come back
29
Q

What are the chemo complications for GI and how do we address them?

A
  • Nausea/vomiting
    • common but manageable w/ anti-emetics
    • give cool or bland foods
  • Change in appetite
    • some kids lose sense of taste
    • This was the storry about flaming hot cheetos being popular cause they can actually taste those
  • Mucositis- Mucosal irritation/Mouth sores
    • Provide good oral hygeine
    • “Magic mouthwash” - has benadryl, lydocane and an antacid - that helps them feel better for mouth care and inflammation and acids in stomach that add to pain
  • Constipation
    • stool softeners
30
Q

How does chemo effect the GU system?

A
  • Chemo is gonna be in bladder
  • Problem is it just sits there against the bladder tissue and can cause hemorrhagic cystitis
  • Will give lots of fluids, up to TWICE their proper maintenance dose - trying to flush that out
  • MESNA is med protects the bladder tissues
31
Q

How is radiation treatment delivered?

A
  • In divided treatments (about 5mins ea), every day, over weeks
  • Delivered to exact location of cancer cells (unlike chemo)
32
Q

SFX of radiation?

A
  • fatigue
  • skin damage
  • hair loss
  • n/v
  • low blood counts
33
Q

Why can radiation treatment be taxing on a family?

A

Where they live, type of transportation they need to take (public can expose to infection), etc

34
Q

Why might surgery be necessary after chemo or radiation therapy?

A
  • to get anything missed (or to make tumor smaller prior to resection), or vise verse
35
Q

Key things to remember about pre-op care?

A
  • Consent/assent
  • Fam/Pt education on what’s about to happen
    • developmentally appropriate for kid
  • Parents stay with kid until the last second and parent brought back in for the wake up
36
Q

Key things to remember post-op?

A

Usual. Watch for:

  • bleeding,
  • respiratory issues,
  • infection,
  • pain
37
Q

How do we deal with our kiddos re: body issues from procedures?

A
  • communicate at developmental level
  • Educate on care
  • Support emotions
  • Connect w/ support groups w/ peers
38
Q

Where do stem cells come from?

A
  • bone marrow,
  • umbilical cord blood,
  • peripheral blood
39
Q

Is it possible to purposefully wipe out a pt’s bone marrow, if so, why?

A
  • Yes
  • In the case of diseased bone marrow, you’d want to wipe it out so it can be replaced by stem cells
40
Q

How are stem cells administered?

A

into the blood stream where they will migrate to the marrow.

41
Q

What is Graft vs Host disease?

A
  • biggest concern w/ stem cell and bone marrow transplants
  • When body rejects replacement
  • We want to suppress the body’s response to this
42
Q

What are Bio agent treatments?

A
  • Naturally occurring substances that are in the body that influence the immune system functions
  • May give “monoclonal antibodies” (a synthesized protein) for specific types of cancer
  • usually used in conjunction with some other type of tx
43
Q

What are CAM therapies and what is our responsibility with them?

A
  • Complementary Alternative Medical Therapies
    • Family/religious/spiritual/cultural traditions
  • We need to build a trusting relationship w/ family so that they feel safe discussing and we can ensure safety
44
Q

What is Tumor Lysis Syndrome?

A
  • It is when the tumor ruptures and its contents are spread throughout the body
  • Can cause metabolic abnormalities/electrolyte imbalances - ex. hyperkalemia, hypocalcemia
45
Q

How is Tumor Lysis Syndrome managed?

A
  • Hydration
  • Serial labs
  • Monitor I/Os
  • Meds for specfic abnromality/imbalance
    • ex. if hyperkalemia, reduce potassium
46
Q

What is the Nadir of treatment?

A

The point after treatment when blood counts are very very low and the pt is @ highest risk for infections

47
Q

Why do parents need to know the nadir of treatment?

A

So they can take extra precautions to keep their kid at home and safe from infections.

48
Q

To know the nadir, we need to know the Absolute Neutrophil Count.

What is its formula and what level triggers neutropenic precautions?

A
  • ANC = neutrophils X WBCs
  • or
  • ANC = (%segs + %bands) x WBCs
  • an ANC < 500 is the trigger point for neutropenic precautions
49
Q

What are neutropenic precautions?

A
  • Neutropenic precautions are steps you can take to prevent infections if you have moderate to severe neutropenia.
  • Neutropenia is a condition that causes you to have low neutrophils in your blood.
50
Q

What is tumor compression, where can it occur and why do we care?

A
  • Tumor compression is when a tumor grows and pushes against tissues, organs, vessels, etc
  • It can occur anywhere in the body
  • We care because if it compress the spinal cord, esophagus, airway, etc - its bad news bears
  • s/s will manifest according to location
51
Q

Why do some kids that have faced trauma have a hard time relating to other kids and their problems and what do we do about it?

A
  • Other kids typical problems are just nothing compared to almost losing your life or limb.
  • This can lead to isolation
  • We should connect w/ support groups/programs

PEDS Unit 3 (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions