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Pediatrics > Pediatrics Test 2: Cancer and Dying > Flashcards

Pediatrics Test 2: Cancer and Dying Flashcards

0
Q

What types of children are more prone to cancer?

A

After treatment of chemotherapy and radiation
Children with AIDS
certain genetic syndromes
Down syndrome is more likely for leukemia

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1
Q

What are the most common types of childhood cancer?

A

Leukemia

cancer of brain and CNS

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2
Q

What are the cardinal symptoms of cancer?

A 
Unusual mass or swelling
Unexplained paleness and loss of energy
Sudden tendency to bruise
Persistent localized pain or limping (osteosarcoma)
Prolonged, unexplained fever or illness
Frequent headaches, often with vomiting 
Sudden eye or vision change 
Excessive, rapid weight loss
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3
Q

List the treatment options for cancer?

A

Surgery
Chemotherapy
Radiotherapy

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4
Q

How is surgery an option for chemotherapy

A

Biopsies
Excision of tumor
- palliative: reduce bulk to decrease pain
- curative

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5
Q

What is chemotherapy treatment?

A

Primary option
Interfere with production of nucleic acids, DNA or RNA
Given in combination
Very toxic to cell tissue

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6
Q

What is radiotherapy treatment?

A

Come a long way in 30 years

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7
Q

List the adverse reactions of cancer treatment?

A 
Bone marrow suppression
GI suppression
Alopecia
Fatigue
Infertility
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8
Q

What is bone marrow suppression?

A

Anemia (don’t develop hemoglobin or hematocrit in normal amounts. Decreased oxygen carrying capacity)
Neutropenia : decrease neutrophils which is a indicator that chemo is working
Thrombocytopenia : decreased platelet count if get below 100,000. At risk for bleeding so enforce bleeding risk.
- such as invasive procedures, soft toothbrush, electric shavers, avoid aspirin and NSAIDS

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9
Q

What are the GI disturbances of cancer?

A

Anorexia : small frequent meals, increase calorie and protein, good oral care
Nausea and vomiting
Diarrhea : keep hydrated. Good hair and skin care. Fiber, limit fat and spice food. Avoid anti-diarrhea
Stomatitis : ulceration in mouth, get paradex mouthwash for pain relief

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10
Q

What is alopecia?

A

Loss of hair.
It will regrow but color and texture will change
Give them choices on how to use it and what the want to do when they are bald

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11
Q

How is fatigue and adverse reaction?

A

Exercise them
Allow more time for activities
Balanced meals

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12
Q

What is extravasation signs and symptoms?

A

Blister
Ulceration
Tissue necrosis

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13
Q

Extravastion nursing interventions?

A

Stop infusion
Notify MD
moist compress
-cold except Vinca alkaloids then use warm

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14
Q

What are the signs and symptoms of Anaphylaxis?

A 
Urticaria
Angioedema
Flushing
Rashes
Difficulty breathing
Hypotension
Nausea and vomiting
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15
Q

What are the radiotherapy adverse effects?

A

GI : nausea, vomiting, diarrhea, and anorexia
Skin : alopecia, dry or moist desquamation
Head : mucositis, parotitis, sore throat, loss of taste, dry mouth
Urinary bladder : rarely cystitis
Bone marrow : myelosuppression

16
Q

Bone marrow transplantation, when it is chosen

A

Treatment of childhood cancer that is not curable via other means

17
Q

How does one use a bone marrow transplant

A

Utilizes lethal doses of chemotherapy to rid body of malignant cells

18
Q

What do bone marrow transplants require

A

Suppression of immune system to prevent rejection

19
Q

What are the types of bone marrow transplant?

A

Autologous bone marrow transplant
Allogenic bone marrow transplant
Umbilical cord blood transplant

20
Q

What is retinoblastoma

A

Unilateral or bilateral
Causes blindness in eyes
Last resort is enuclieation (removal of eye)

21
Q

What is palliative care?

A

Focus on preventing or relieving child’s symptoms and support child and family

22
Q

What can children understand about death by the age of 7?

A

Universality : all living things die, it is inevitable, timing is unknown
Irreversibility : once the physical body dies it does not become alive again
Non functionality : once a living thing dies, all life-defining capabilities to cease
Causality : external and internal events can cause death
No corporal continuation : some from of personal continuation exists after death

23
Q

What is the principle of double effect?

A

An action that has one good (intended) and one bad effect is permissible if there must be a compelling or proportionate reason for permitting the foreseeable bad effect to occur.

24
Q

What are some symptoms that dying children may experience?

A

Pain
GI : anorexia, n/v, constipation and diahrrea
GU : UTI, urinary retention
Hematologist : anemia, bleeding
Respiratory : cough, congestion, SOB, wheezing
CNS : fever, chill, sleep disturbance, seizures
Integumentary : dry skin, rash, itching, edema, pressure sores
Emotional : fear, anxiety and depression

25
Q

What are physical signs of approaching death?

A 
Loss of sensation in lower extremities 
Sensation of heat: body feels cold
Loss of senses : hearing is last to fail
Confusion, LOC, slurred speech
Loss of bowel and bladder control
Decreased appetite and thirst
Difficulty swallowing
Change in respiratory pattern
Weak, slow pulse, decreased blood pressure
26
Q

What care can be provided during death?

A 
Frequent mouth care
Good physical hygiene
Continue medications to manage symptoms
Discontinue unnecessary medications
Encourage family to discus death
Encourage family to speak with child in calm, reassuring voice
Provide family surrounding and objects
Allow spiritual and cultural rituals
Allow Family to be alone with child after death
27
Q

What. Are symptoms of grief

A 
Sensations of somatic distress
Preoccupation with image of deceased 
Feelings of guilt
Feelings of hostility
Loss of usual patterns of conduct
28
Q

How do you support e grieving families

A

Stay with them, listen, cry
Avoid judgmental statement, rationalizationz, artificial consolation
Refer to help groups
Attend funeral or visitation
Refer to dead children by name, share memories
Emphasize that grief is a painful process that can take years

Pediatrics (10 decks)

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