Oncology

Question 1

What is neutropenia

Answer 1

you don’t have a fully functioning immune system + low WBCs

Question 2

Nursing care Neutropenia

Answer 2

neutropenic precautions, no rectal temps, watch for infection

Question 3

Patient education for neutropenia

Answer 3

hold vaccines till 6-12 months, teach s&s of infection

Question 4

Prognostic factors in cancer

Answer 4

Type of malignancy, age at diagnosis, primary site, extent of disease, biologic/ genetic markers

Question 5

What is Tumor Lysis Syndrome

Answer 5

During treatment, tumor cells lyse and uric acid, phosphorus and potassium levels increase, and calcium levels decrease

Question 6

Patients at risk for TLS

Answer 6

Burkett’s lymphoma, ALL, AML

Question 7

Management of TLS

Answer 7

frequent labs, hydration, diuretics, electrolyte supplements, allopurinol

Question 8

Cause of TLS

Answer 8

Induction of chemo treatment

Question 9

Nursing care of bone marrow aspiration

Answer 9

give sedation and pain meds, comfort items, non-pharmacologic pain management, watch for infection and complications

Question 10

Patient education of bone marrow aspiration

Answer 10

what will happen during the procedure, signs and symptoms of infection

Question 11

Initial CBCs in ALL

Answer 11

WBCs- increased
Hgb- decreased
Platelets- decreased
Neutrophils- decreased
Blast cells- present

Question 12

IVF in initial ALL treatment

Answer 12

1.5x maintenance fluid, allopurinol (uric acid buildup)

Question 13

Why do we give intrathecal chemo?

Answer 13

Blood brain barrier prevents chemo from entering the CNS

Question 14

Types of brain tumors

Answer 14

Supratentorial and infratentorial

Question 15

Priorities of care for brain tumor patients

Answer 15

Surgery, chemo, neuro exam, safety, ABCs, explaining procedures at the correct level

Question 16

Supratentorial brain tumor s&s- do not study for exam 3

Answer 16

increased ICP, vision changes, headache, emesis, change in behavior, school difficulties, seizures, Parinaud’s Syndrome (paralysis of upward gaze)

Question 17

Infratentorial brain tumor s&s- do not study for exam 3

Answer 17

ataxia, head tilt, nystagmus, cranial nerve palsy, increased ICP, morning emesis, back pain, loss of bladder, bowel function

Question 18

Brain tumor treatment

Answer 18

neuro exam, safety, chemo, surgery

Question 19

Hodgkins disease- s&s and risk factors

Answer 19

Peaks in adolescence
Males more than females
cervical lymphadenopathy (Painless, rubbery, firm, movable node)
fatigue, loss of appetite

Question 20

Hodgkins “B” symptoms

Answer 20

fever higher than 38, unintentional weight loss greater than 10% body weight in 6 months, drenching night sweats

Question 21

Mucositis & N/V: signs and causes

Answer 21

mouth ulcers, emesis (caused by chemo, radiation)
N/V can be anticipatory, delayed or chronic

Question 22

Why do we give more than one chemo drug?

Answer 22

Chemotherapy is specific to the cell cycle, so you need more than one to address the whole cycle

Question 23

Mucositis and N/V care

Answer 23

Bland diet, soft toothette, frequent mouth rinses, local anesthetic, pain and symptom control, premedicate and continue to medicate

Question 24

Nursing care of kids with mediastinal masses

Answer 24

watch respiratory status, comfortable positioning, TLS, anesthesia

Question 25

Care of kids receiving radiation therapy

Answer 25

Hgb is 10 or more, dressings are clean, premeds, lotions, no restrictive clothing, watch for mucositis, watch skin in general

Question 26

Wilms/ Neuroblastoma assessment

Answer 26

Respiratory difficulty, Fatigue, Fever, Periorbital Ecchymosis (“racoon eyes”), “Blueberry Spots”, Opsoclonis- Myoclonis, Horner’s syndrome

Question 27

Wilms/ Neuroblastoma nursing care

Answer 27

Watch respiratory status, Abdominal girth, Palpation, Monitor BP, Watch urine output

Question 28

Why are some cancers treated with chemo first vs. surgery and vice versa?

Answer 28

Depends on location- If you have a brain tumor for example, you don’t have the luxury of waiting for it to shrink, surgery first; Wilms- radiation to shrink, then surgery

Question 29

Ewings Sarcoma signs and symptoms

Answer 29

*Affects long, flat bones (pelvis, vertebrae) *Presents in children ages 10-25 *Presenting symptoms: pain, activity intolerance *Prognosis: 50-70% (if mets, 20%) *Treatment: surgery, Radiation, chemo

Question 30

Cell cycle specific chemo

Answer 30

chemotherapies disrupt specific specific parts of the cancer cell cycle