T3-Childhood Cancer Flashcards
What therapy is curative, palliative?
Radiotherapy
Complications of diseases: What is acute tumor lysis syndrome?
-Hyperuricemia
Complications of disease: What is superior vena cava syndrome?
Compression of mediastinal structures
For kids have surgery, what is important?
Age appropriate pre-op and post-op teaching
Radiation therapy: Pick ____ when available
Distraction
Chemotherapy: Manage side effects–Need to monitor ____.
Growth
What are some side effects to chemotherapy?
- N/V
- Mucositis
- Diet
If a child with chemo has N/V, what is a common DOC?
Ondansetron (zofran)
If a child with chemo has mucositis, what does this mean?
*she said this is an ATI type question a lot
Meticulous mouth care; no viscous lidocaine
Side effects of treatment: Infection-ANC less than ___ be concerned.
Less than 500
Side effects: Hemorrhage- Platelet count less than ____ be concerned and avoid skin punctures, rectal temps, and do mouth care with care
Less than 20,000
Side effect of treatment: Anemia..What does this mean?
Low hgb
Absolute neutrophil count. Less than ___ is risk of infection
Less than 1000
Absolute neutorphil count. Less than ___ is MAJOR risk of infection
Less than 500
Nutrition: Check mouth for what? What kind of meals can be eaten?
Check mouth for viscous lidocaine and antifungals
Meals: Small, frequent high protein, high CHO
What is alopecia?
A side effect of treatment that is hair loss out in clumps (patchy baldness) —wig before hair falls out
Side effect of treatment: Hemorrhagic cystitis. What is this?
Chemical irritation of bladder
Side effets of treatments: Why do we give steroids?
Increased appetite and sense of well being—body image alterations, mood changes
How is infection prevented?
HAND WASH
Keep away from crowds
How do you prevent bleeding?
No sharp toys
No rectal temps
For cancer patients, what is a very important key point?
STRICT I&O!!!
*Hydration is very important!
Why is health promotion of dental care important?
Dentition is affected
Health promotion: Is it okay to give live, attenuated vaccines?
No
Immunizations: If vaccinated 2 weeks before or during chemo, they need to be ______ after chemo
Revaccinated
What is the most commonly diagnosed malignancy in children under 14?
Leukemia
Leukemia is a malignant disease of the blood forming tissues characterized by uncontrolled growth of _____ that fail to mature (____)
Uncontrolled growth of WBC (leukocytes) that fail to mature (blast cells)
What are the 2 main types of leukemia?
Acute lymphocutic leukemia (ALL) & Acute myelocytic leukemia (AML)
What kind of cells are involved in acute lymphocytic?
Overproduction of immature WBC resembling lymphoblasts
Leukemia risk factors for ALL? (4)
- Males
- Caucasians
- Siblings of child with ALL
- Downs syndrome
Some S&S of Leukemia?
- Fever
- Infection
- Pallor
- Bone pain
- Petechiae
- Lethargy
- Decreased hemoglobin
- Bleeding
- Hepatosplenomagagly
- Decreased leukocytes
- Increased blasts
- Decreased platelets
- Irritability
- Lympadenopathy
What are the 3 phases of chemo?
- Induction
- Sanctuary
- Maintenance
What is the purpose of induction phase of chemo? What does it include? How long is this phase?
Purpose: To achieve remission
Includes: Prednisone, vincristine, and L-asparaginase
Phase lasts 4-6 weeks
What is the purpose of sanctuary phase of chemo? How long does this last?
- To prevent leukemia cells from invading CNS
- To destroy those leukemia cells already in CNS
2-3 weeks
What is the purpose of the maintenance stage of chemo? How long does it last? What drugs?
Purpose: Maintain remission
Lasts: 2-3 YEARS
Drugs: Variety
Chemo for leukemia: What does it mean if you are in remission?
Decrease blasts and normal formation of other blood elements
Chemo for leukemia:
What does it mean if you are in relapse?
-Increase in blasts and non-normal formation of other blood elements
Why is nursing management difficult for leukemia?
Due to multisystem effect
What are some psychosocial implications during treatment of cancer? (several, list as many as you can)
- Coping with shock of diagnosis
- Mastering new med jargon
- Know the roles of different caregivers to child
- Supporting sibs..still giving them enough attention
- Manage side effects
- Try to normalize family lifestyle
- Tell child, friends, and relatives of diagnosis
Psychosocial implications at the end of treatment: Why are there conflicting emotions?
It is a long awaited long desired milestone
Hodgkins Disease:
- What age?
- How is it staged?
- What kind of lymph nodes?
- Where is sentinel node?
- What is the cell diagnostic for this?
- What is treatment?
*=she said to know this!
- 15-19 year olds
- Stage I-IV and A vs. B for symptoms
- Painless enlargement of lymph nodes
- Sentinel node is the left clavicle
- Reed Sternberg= Cell diagnostic for HODGKINS
- Treatment: Radiation and chemo
What is the second most common cancer?
Brain tumors
What is the most common type of brain tumor?
Gliomas
What tumor is difficult to excise?
Infratentorial (over half of ped brain tumors are this type)
*the other type is supratentorial
What is most common finding of brain tumor?
Headache
Brain tumor: When is vomiting? Is nausea common?
Vomiting is usually in MORNING often WITHOUT nausea
Brain tumor in infants: Decreased or increased head circumference? What kind of fontanel?
Increased head circumference; TENSE fontanel
