Week 7 TUES Flashcards
Peds Cellular Regulation (oncology)
T or F signs of leukemia are often subtle and difficult to recognize
TRUE!
15 y.o. w/ osteosarcoma in distal femur is having cough, dyspnea, and chest pain. Based on these findings the nurse suspects metastasis where?
Lungs
A child with cancer has developed neutropenia w/ an isolation w/ neutropenic precautions. What nursing assessment takes priority for this child?
infection s/s
- vital signs esp temp
What is the most frequent type of childhood cancer?
leukemia
Leukemia that has infiltrated the CNS s/s include…
- facial palsy and vision problems
What agent should the nurse anticipate administering to this child after noting significant reduction in RBCs?
- epoetin alfa
When to give n/v medication to make it the most effective during chemo?
administer before chemo
difference between finding adult and childhood cancers
children cancer unlike adults are often detected accidentally at screenings
Why does radiation take so many rounds?
- cells are only susceptible to treatment by radiation during certain phases of the cell cycle
The nurse is caring for a 7-year-old girl who is undergoing a stem cell transplant. What information would be the priority for the nurse include in the child’s care plan?
Assessing for petechiae, purpura, bruising, or bleeding
Limiting blood draws to the minimum volume required
Administering antiemetics around the clock as ordered
Monitoring for severe diarrhea and maculopapular rash
D
- monitor for severe diarrhea and maculopapular rsh> post stem cell s/s
A nurse is giving instructions to the caregiver of a patient who is receiving chemotherapy regarding how best to care for the child during this period of treatment. What should the nurse mention to them?
Keep the child away from people with known infections
Give the child aspirin to help manage pain
Be sure that the child receives only live-virus vaccines
Give the child folic acid supplements
A!
- keep the child away from people with known infections> child more at risk for infection w/ low immune system
A child with cancer is receiving chemotherapy, and their caregiver is concerned that the nausea and vomiting associated with chemo are reducing their ability to eat and gain weight appropriately. What is the most appropriate nursing action?
Administer an antiemetic at the first hint of nausea.
Offer the child’s favorite foods to encourage eating.
Start antiemetic drugs prior to chemotherapy infusion.
Maintain IV fluid infusion to avoid dehydration.
C!
- start antiemetic drugs prior to chemotherapy infusion
- start before> best results
The process by which cells replicate, proliferate, and grow
Cellular regulation
T or F cancer is the most common cause of death from diseases in children older than 1 year of age
TRUE!!
result of alteration in cellular regulation resulting in out of control cell growth, generally means malignant
Cancer
a solid mass/growth of the abnormal cells
Tumor
refers to cells that have abnormal proliferation and/or alterations in cellular regulation (can be benign or malignant).
Neoplasm
Exemplars that are solid tumors
- neuroblastoma
- osteosarcoma
Hematologic malignancy is cancer where?
blood or blood-forming tissues
- Acute Lymphoblastic Leukemia
Low neutrophils means ____ risk for infections
- higher risk for infections
Treatments included in care for childhood cancer
- radiation
- chemotherapy
- stem cell transpaltation
- surgical removal of the tumor
Using child’s own bone marrow
autologous
stem cell transplant use of a donor stem cells and injected into pt
allogenic stem
Neutropenic precautions include…
- NO fresh fruit. veggies, flowers
- NO live vaccines
- wash hands frequently
- restrict/ avoid ill visitors
- frequent vitals
- use soft toothbrush
- wear mask when out of room
Even in cancers not originating in the hematologic system, the disease or its treatment can impact blood cell counts and function. This can result from the body’s response to the tumor, nutritional deficiencies, or side effects of aggressive treatments
secondary effects
difference between children and adults w/ cancer
- children cells divide more rapidly
- childrens immune system is less mature> more suspetable to infections
- organ development is still developing> metabolism of chemo is different> wt based!!
- both have different psychosocial factors
- children tolerate chemo better than adults
- cause is unknown
- abnormal lymphoblast develop in the blood forming tissues and lack ability to fight infections
- Lymphoblasts proliferate and replace the normal bone marrow cells
- the proliferation impacts metabolism as they take the nutrients vausing fatigue, wt loss, muscle loss
- Leukemia cells can invade the bone, joint, lymph nodes, CNS
Acute Lymphoblastic Leukemia
- Arises from the embryonic neural crest cells
- Usually occurs in the abdomen but can be found in the chest or retroperitoneum
- The most common extracranial solid tumor and the second most common tumor in children
Neuroblastoma
- Forms in embryonic mesenchymal tissue of the bones, most commonly the long bones (humerous, tibia, femur)
osteosarcoma
High WBC means_____ prognosis and Low WBC mean_____ prognosis
poor, better/ good
IVIG is a common treatment for what type of cancer
Acute Lymphoblastic Leukemia
Abdominal pain and swelling are common with what cancer?
Neuroblastoma
Abnormal gait and dull bone pain is common for what type of cancer?
osteosarcoma
T or F the treatment process for Acute Lymphoblast Leukemia is short and easy
FALSE
- it is actually long and complex with many stages
Caring for the dying child includes
- advocate for child and caregivers
- clarify terminology, nursing interventions, providing support
- pain assessment, management, and documentation
- participate in interdisciplinary care planning
- explain what we are doing
- Ask permission to touch pt
