Chapter 24: Nursing Care of the Child With an Alteration in Cellular Regulation/Hematologic or Neoplastic Disorder
The nurse is caring for a toddler taking ferrous sulfate for severe iron-deficiency anemia. Which report by the parent is most concerning?
"I mix ferrous sulfate with milk in a bottle."
Parents tell the nurse who is admitting their infant for a well-child exam that they recently saw a "white glow" in their child's left pupil. What is the nurse's best response?
"I will report this to the pediatrician."
A nurse is providing dietary interventions for a 5-year-old with an iron deficiency. Which response indicates a need for further teaching?
"Red meat is a good option; he loves the hamburgers from the drive-thru."
The parents of a child diagnosed with rhabdomyosarcoma ask the nurse to explain what this means. What is the nurse's best response?
"The tumor is in the muscle."
A client with cancer is diagnosed with typhlitis. Which emergency intervention would the nurse perform?
Administer broad-spectrum antibiotics intravenously.
A group of nursing students are studying information about childhood cancers in preparation for a class examination. They are reviewing how childhood cancers differ from adult cancers. The group demonstrates understanding of the information when they identify what location as an unlikely site for childhood cancer?
Bladder
The nurse is preparing a discharge teaching plan for the parents of an 8-year-old girl with leukemia. Which instruction would be the priority?
Calling the doctor if the child gets a sore throat
A nurse is providing care to a child with hemophilia who is experiencing muscle and joint involvement related to the bleeding. Which would the nurse include as an adjunctive measure to control bleeding?
Compression
The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of:
Ewing sarcoma.
A preschooler who received chemotherapy in the pediatric oncology outpatient department 1 week ago now has a temperature of 101.5°F (38.6°C). Which is the most appropriate response by the nurse?
Have the parent bring the child to the pediatric oncology clinic as soon as possible.
The nurse is assessing a 2-year-old girl whose parents noticed that one of her pupils appeared to be white. Which assessments should the nurse expect to find if the girl has retinoblastoma? Select all that apply.
History reveals strabismus. Assessment discloses hyphema in one eye. Observation confirms cat's eye reflex in pupil. Parents report that the child has headaches.
A nurse is talking with parents of a child who is to begin radiation treatment for cancer. The parents ask, "What kind of effects might we see soon after the child starts treatment?" Which effects would the nurse include when instructing the parents? Select all that apply.
Loss of appetite Nausea Vomiting Skin Redness
A school-aged child is admitted to the hospital with a vaso-occlusive sickle cell crisis. Which measure in the child's care plan should be given priority?
Maintaining fluids through an intravenous line
When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority?
Monitor the site dressing and vital signs.
The pediatric nurse is explaining to a new graduate nurse the differences in planning well-child maintenance for a child with cancer. Which statement by the new nurse demonstrates understanding of the teaching?
No routine live vaccines are administered while on chemotherapy.
A child diagnosed with hemophilia presents with warm, swollen, painful joints. Which action will the nurse take first?
Prepare to administer factor replacement medication
The nurse is teaching the parents of a 15-year-old boy who is being treated for acute myeloid leukemia about the side effects of chemotherapy. For which symptoms should the parents seek medical care immediately?
Temperature of 101°F (38.3°C) or greater
Which symptom would lead the nurse to suspect that a child is developing a common side effect of vincristine?
The child says the fingertips feel numb.
A 9-month-old infant with iron-deficiency anemia is given ferrous sulfate therapy. Which assessment would best help the nurse determine that the infant is actually taking it daily?
The stools are black
Wilms tumor is suspected in a 5-year-old child. Which action would be avoided?
abdominal palpation
A 5-year-old child is at the pediatric clinic for a well-child visit. Which symptom alerts the health care provider that this child might have acute lymphoblastic leukemia (ALL)?
lethargy, bruises, and lymphadenopathy
A hospice nurse is providing at-home care to a child with end-stage cancer. The nurse is developing a plan of care to manage the child's pain. Which medications will the nurse likely include?
opioids
A 3-year-old boy has been brought to the doctor's office with symptoms of anorexia and abdominal pain. A blood test reveals a lead level of 20 μg/100 mL. The child is prescribed an oral chelating agent. On discharge, the nurse should counsel the parents regarding:
removal or covering of flaking paint on the walls of the home.
The child has been diagnosed with cancer and is being treated with chemotherapy. Which findings are common side effects of this type of treatment? Select all that apply.
The child's mother states, "It seems like he catches every bug that comes along." The child has no hair on his head. The child's mother states that she often has to repeat herself because he can't hear very well. The child reports feeling nauseated.
A nurse is caring for a child diagnosed with von Willebrand disease who is receiving desmopressin as part of the treatment regimen. In relation to desmopressin administration, what assessment finding(s) is important for the nurse to monitor? Select all that apply.
electrolyte balance intake/outtake heart rate
After teaching a group of students about hemophilia, the instructor determines that the students have understood the information when they identify hemophilia A as involving a problem with:
factor VIII.
A school nurse is teaching a group of parents about signs and symptoms of cancer in children. Which symptom is an early sign of a brain tumor?
headache, vision changes, and vomiting
