Pediatric Cancer Flashcards
What is the leading cause of death by disease for children
Cancer
What is the most common form of cancer in children?
Leukemia (ALL)
True or False: Lifestyle factors can impact the likelihood of all age groups acquiring cancer?
False. Lifestyle factors are NOT a cause of childhood cancers
What is the most promising theory as to the cause of childhood cancer?
A genetic alteration that leads to uncontrolled proliferation
What are the usual labs acquired for childhood cancer?
CBC, CMP (complete metabolic panel), UA (urine analysis)
Name some of the cardinal symptoms of cancer (8):
- ) Unusual mass or swelling
- ) Unexplained paleness and loss of energy
- ) Sudden tendency to bruise
- ) Persistent, localized pain or limping
- ) Prolonged, unexplained fever or illness
- ) Frequent headaches, often with vomiting
- ) Sudden eye or vision change
- ) Excessive, rapid wt loss
When should sedation be used with children during a bone marrow aspiration?
Always! May use conscious or unconscious, but must always use something.
Adults may only receive local anesthetics.
How do biologic response modifiers (a.k.a. monoclonal antibodies) work on cancer cells?
They change the host’s biologic response to cancer cells.
How are clinical trials conducted to test new treatments?
Control group receives the best available therapy currently known, while the experiment group receives treatment that is thought to be even better.
Why must the IV site be carefully watched when chemotherapy is being administered?
Chemo is very vesicant (sclerosing) and can cause serious damage to local tissue if allowed to infiltrate.
Why does chemo cause baldness and what other types of cells/sites may be affected by chemo?
It will affect all cells that have a high proliferation rate. Cells (aside from tumor cells) that have a high proliferation rate include hair, mucosal, GI tract, bone marrow, and skin).
What are potential hypersensitivity reactions that may be observed with chemo?
Urticaria, angioedema, flushing, rashes, difficulty breathing, hypotension, and N/V.
What steps does a nurse immediately take if a hypersensitivity reaction to chemo is suspected?
- ) D/C the drug
- ) Flush IV line with NS
- ) Monitor vital signs
What is an “allogenic” bone marrow transplant?
Bone marrow received from a donor.
Why is umbilical cord blood an option for bone marrow transplant?
It is a rich source for hematopoietic stem cells
What is an “autologous” bone marrow transplant?
Uses the patient’s own marrow from disease-free tissue
How does Bone Marrow Transplant differ from Peripheral Stem Cell Transplant?
Differs in how the collection is performed.
BMT is done by aspirating bone marrow.
PSCT is done by administering a colony stimulating factor to encourage proliferation of stem cells, that are collected by a filtering (apherisis) machine from the blood and later transfused back to the patient
Both methods infused through a Central line.
What is the cause of abnormalities in tumor lysis syndrome?
Mass release of intracellular contents into bloodstream when malignant cells die.
What abnormal changes are found in the bloodstream from tumor lysis syndrome?
Hyperuricemia, Hypocalcemia, Hyperphosphatemia, Hyperkalemia
What are the potential serious complications of tumor lysis syndrome?
Acute renal failure and death
How is tumor lysis syndrome prevented?
Prevented with IV hydration and medication to decrease uric acid levels (Allopurinol)
What are the risk factors for acute tumor lysis syndrome?
Large tumor burden, sensitivity to chemotherapy, and high proliferative rate.
What are the clinical symptoms of acute tumor lysis syndrome?
Flank pain, lethargy, N/V, oliguria, pruritus, tetany, and altered level of consciousness.
How is neutropenia treated?
Administering colony-stimulating factors (Neupogen).
What temperature warrants being brought to the ER?
100.5 or greater
What common OTC meds for fevers should be avoided and which one is allowed (*Test question)
Aspirin and Ibuprofen. May take Tylenol.
What is the best way nurses can take care of kids with N/V from treatment?
Administer zofran as scheduled. Also will give other antiemetics such as emend prior to chemo as preventive
Aside from IMMEDIATELY notifying MD, what can nurses do if mouth ulcers develop?
Administer magic mouth wash, Allow children to select foods they can eat (soft bland foods may feel best, avoid hot, cold, and spicy foods)
How should nurses advise parents regarding alopecia?
Hair will grow back within 3-6 months after completing treatment, may have a different texture.
Protect from sunlight.
What are potential side effects to chemo treatment?
- ) Infection/Neutropenia
- ) Hemorrhage
- ) Anemia
- ) N/V
- ) Altered nutrition
- ) Mucosal ulceration
- ) Neuropathy
- ) Hemorrhagic cystitis
- ) Alopecia
- ) Steroid effects (Moon face, mood swings)
