The Child with Cancer C25

Decrease in platelets. The child and family should be alerted to avoid risk of injury.

Myelosuppression, associated with chemotherapeutic agents or some malignancies such as leukemia, can cause bleeding tendencies because of a

Abdominal swelling. Aditionally; weight loss, hematuria, and occasionally hypertension.

The nurse is admitting a child with a Wilms tumor. Which is the initial assessment finding associated with this tumor?

surgery and chemotherapy

The nurse is taking care of an adolescent with osteosarcoma. The parents ask the nurse about treatment. The nurse should make which accurate response about treatment for osteosarcoma?

Stop the infusion immediately. If an allergic reaction is suspected, the drug should be immediately discontinued. Any drug in the line should be withdrawn, and a normal saline infusion begun to keep the line open.

The nurse is administering an IV chemotherapeutic agent to a child with leukemia. The child suddenly begins to wheeze and have severe urticaria. Which is the most appropriate nursing action?

bradycardia, hypertension, and irregular respirations. Cushing's triad is a hallmark sign of increased ICP

The nurse is monitoring a 7-year-old child post surgical resection of an infratentorial brain tumor. Which vital sign findings indicate Cushing's triad?

When the hair regrows, it may be a different color or texture. The hair usually grows back within 3 to 6 months after cessation of treatment. The head should be protected from sunlight to avoid sunburn.

The nurse is preparing a child for possible alopecia from chemotherapy. Which should be included?

Chlorhexidine gluconate (Peridex), Antifungal troches (lozenges) or mouth wash, Lip balm (Aquaphor). Agents that should not be used include lemon glycerin swabs (irritate eroded tissue and can decay teeth), hydrogen peroxide (delays healing by breaking down protein), and milk of magnesia (dries mucosa).

The nurse is preparing to give oral care to a school-age child with mucositis secondary to chemotherapy administered to treat leukemia. Which preparations should the nurse use for oral care on this child?

bone fractures

what is commonly seen in an osteosarcoma?

CNS disease. For certain children, CNS prophylactic therapy is indicated. This drug regimen is used to prevent CNS leukemia

A child with leukemia is receiving triple intrathecal chemotherapy consisting of methotrexate, cytarabine, and hydrocortisone. What will the triple intrathecal chemotherapy prevent?

On the inoperative side with the head of bed elevated 20 to 30 degrees

In which position should the nurse place a 10-year-old child after a large tumor was removed through a supratentorial craniotomy?

abdominal mass, sore throat or ear pain, and ecchymosis of conjunctiva

A clinic nurse is conducting a staff in-service for other clinic nurses about signs and symptoms of a rhabdomyosarcoma tumor. Which should be included in the teaching session?

Bone involvement. The invasion of the bone marrow with leukemic cells gradually causes a weakening of the bone and a tendency toward fractures. As leukemic cells invade the periosteum, increasing pressure causes severe pain.

A boy with leukemia screams whenever he needs to be turned or moved. Which is the most probable cause of this pain?

IV infusion. Bone marrow from a donor is infused intravenously, and the transfused stem cells will repopulate the marrow.

An adolescent will receive a bone marrow transplant (BMT). The nurse should explain that the bone marrow will be administered by which route?

Femur. Osteosarcoma is the most frequently encountered malignant bone cancer in children. More than half occur in the femur. After the femur, most of the remaining sites are the humerus, tibia, pelvis, jaw, and phalanges.

A nurse is conducting a staff in-service on childhood cancers. Which is the primary site of osteosarcoma?

Allogenic. Syngeneic marrow is from an identical twin. Autologous refers to the individual's own marrow.

A young boy will receive a bone marrow transplant (BMT). This is possible because one of his older siblings is a histocompatible donor. Which is this type of BMT called?

A Neuroblastoma is a silent tumor with few symptoms. In more than 70% of cases, diagnosis is made after metastasis occurs, with the first signs caused by involvement in the nonprimary site. In only 30% of cases is diagnosis made before metastasis. Neuroblastomas are the most common malignant extracranial solid tumors in children. The majority of tumors develop in the adrenal glands or the retroperitoneal sympathetic chain. They are not benign but metastasize.

The nurse is teaching nursing students about childhood nervous system tumors. Which best describes a neuroblastoma? a. Diagnosis is usually made after metastasis occurs. b. Early diagnosis is usually possible because of the obvious clinical manifestations. c. It is the most common brain tumor in young children. d. It is the most common benign tumor in young children.

surgery, chemotherapy, radiation.

The treatment of brain tumors in children consists of which therapies?

Headaches and vomiting. Irritability, seizures, fever and poor fine motor control are clinical manifestations of brain tumors, but headaches and vomiting are the most common.

What is the most common clinical manifestation(s) of brain tumors in children?

Amitriptyline

What medication do we give for phantom limb pain?

edematous or eccchymotic face, eye dressing, implanted sphere in the eye covered with red conjunctiva

Which expected appearance will the nurse explain to parents of an infant returning from surgery after an enucleation was performed to treat retinoblastoma?

D The vaccine used for measles, mumps, and rubella is a live virus and can result in an overwhelming infection. Tetanus vaccine, inactivated poliovirus vaccine, and diphtheria, pertussis, tetanus (DPT) are not live virus vaccines.

Which immunization should not be given to a child receiving chemotherapy for cancer? a. Tetanus vaccine b. Inactivated poliovirus vaccine c. Diphtheria, pertussis, tetanus (DPT) d. Measles, rubella, mumps

Enlarged, firm, nontender lymph nodes usually in the cervical or supraclavicular region.

Which is a common clinical manifestation of Hodgkin disease?

C Leukemia is a group of malignant disorders of the bone marrow and lymphatic system. It is defined as an unrestricted proliferation of immature WBCs in the blood-forming tissues of the body. Increased blood viscosity may occur secondary to the increased number of WBCs. Thrombocytopenia may occur secondary to the overproduction of WBCs in the bone marrow. The coagulation process is unaffected by leukemia.

Which is most descriptive of the pathophysiology of leukemia? a. Increased blood viscosity occurs. b. Thrombocytopenia (excessive destruction of platelets) occurs. c. Unrestricted proliferation of immature white blood cells (WBCs) occurs. d. First stage of coagulation process is abnormally stimulated.

Platelets.

Which is often administered to prevent or control hemorrhage in a child with cancer?

Conscious or unconscious sedation

Which is the most effective pain-management approach for a child who is having a bone marrow aspiration?