Chapter 25 Study Guide questions, success book
What bones are typically involved in the following bone cancers: Ewing Sarcoma Osteosarcoma
Ewing- pelvis, long bones of lower extremities, chest wall Osteo- metaphyseal region of bone; often involving long bones
T/F: Lemon glycerin swabs are effective supportive measures for children with oral ulcers
False
T/F: The hallmark metabolic abnormalities of tumor lyis syndrome include hypouricema, hypercalcemia, hypophosphatemia, and hypokalemia
False
T/F: the child receiving chemo should receive all immunizations as scheduled, including live attenuated vaccines
False
which of the following measures should the nurse implement to help with n/v caused by chemo?
Give an antiemetic 30 min prior to the start of the therapy Continue the antiemetic as ordered until 24 hours after chemo is complete remove food that has a lot of odor
On what topics should the nurse educate the parent and child with cancer regarding home care?
Medication schedule s/e of toxicity (signs and symptoms)
The peak age for pediatric bone tumors is ______ years, and occurs more often in ________
15 years; males
A child with a fever who has an absolute neutrophil count lower than 500/mm3 is at risk for what 3 issues?
Overwhelming infection general malaise invasion of organisms producing secondary infections
Chemotherapy agents can be classified according to their ___________
primary mechanism of action
What is the treatment of choice for Ewing Sarcoma?
radiotherapy and chemotherapy
What is the treatment of choice for brain tumors?
removal of tumor without residual neurologic damage
Which of the following can lead to a possible diagnosis of HIV in a child?
repeated respiratory infections intermittent diarrhea poor weight gain
Leukokoria or the cat's eye reflex is indicative of what diagnosis
retinoblastoma
Which nursing diagnosis is most important for a child with Ewing Sarcoma who will be undergoing chemotherapy
risk for fluid volume deficit
What is the most severe neurotoxic effect?
severe constipation
The nurse is teaching an adolescent about Ewing Sarcoma and indicates which as a common site?
shaft (especially of long bones)
What signs may indicate ICP and potential brainstem herniation
sluggish, dilated, or unequal pupils
The nurse is explaining rhabdomyosarcoma cancer o an adolescent. from which of the following muscles does the cancer arise?
striated
Space-occupying lesions located in the chest may cause ___________ and lead to _______________ compromise and _________________ failure
super vena cava syndrome; airway; respiratory
What are the common presenting signs and symptoms for a child with Wilm's Tumor?
painless swelling or mass within the abdomen and firm non-tender mass confined to one side deep within flank
How are most bleeding episodes prevented or controlled?
platelet concentrates or platelet rich plasma
The nurse is instructing the parent of a child with HIV about immunizations. Which of the following should the nurse tell the parent
pnemococcal and influenza vaccines are recommended meningitis immunizations
What neurologic syndrome may develop 5-8 weeks after CNS radiation? How long does it typically last?
post-irritation somnolence; 4-15 days
Why are children undergoing bone marrow transplantation hospitalized for several weeks?
potential for complications
If an amputation is performed for osteogenic sarcoma, the child may be fitted with a temporary ________ immediately after surgery.
prosthesis
Which would be the best nursing intervention for a child with phantom pain after an amputation
provide amitriptyline (Elavil) to help with pain
The parent of a 2 year old who is HIV+ questions the nurse about placing the child in day care. Which of the following is the best response?
the child can go to daycare without restrictions and should be allowed to participate in all activities
The parent of a child diagnosed with Wilm's tumor asks the nurse what the treatment plan will be. The nurse explains the usual protocol for this condition, which information should the nurse give the parents
the child will go to surgery for removal of the tumor and the kidney and will then start chemotherapy
A child is diagnosed with stage IV rhabdomyosarcoma and the parent asks what that means. The nurse provides which of the following explanations
there is distant metastatic disease
Where is the primary site of origin of the tumor in children who have neuroblastoma?
abdomen
The nurse is discharging a child who just received chemo for neuroblastoma. Which of the following statements made by the child's parent indicates a need for additional teaching?
"I will take a rectal temperature daily and repot a temperature greater than 101 immediately to the healthcare provider"
a child with osteosarcoma is going to receive chemotherapy before surgery. which statement by the parents indicates they understood the side effects of neutropenia
"my child will be more at risk for infection"
_________________ is the most common extracranial solid tumor of childhood and the most common cancer diagnosed in infancy
neuroblastoma
What supportive measures can the nurse promote in children with altered nutrition?
oral supplements with high protein/ high cal; use whole milk, add tofu, high fat foods, cook with butter
A child with Ewing sarcoma is undergoing a limb salvage procedure. which of the following indicates the parents understand the procedure
our child will need follow-up lengthening procedures
which of the following lab tests will be ordered to determine the presence of HIV antigen in an infant whose mother is HIV+
p24 antigen assay
blood transfusions with _______ may be necessary to raise the hemoglobin to appropriate levels
packed RBC
The parent of a child with neuroblastoma asks the nurse what the typical signs and symptoms are at first
The signs and symptoms vary depending on where the tumor is located, but typical symptoms include weight loss, abdominal distention, and fatigue
T/F: A satisfactory method of cleaning gums in infants and toddlers is to wrap a piece of gauze around a finger, soak it in saline, and swab the gums, palate, and inner cheek surfaces
True
T/F: dental complications of children who received radiation to the head and neck include caries, periodontal disease, and facial asymmetry
True
T/F: lifestyle related behaviors have little to no effect on childhood cancer
True
T/F:Exposure to immunosuppressive therapy is a risk factor for cancer in children
True
What two medications can be administered to a child receiving chemo who has been exposed to varicella virus in the past 2 days
Varicella-Zoster immune globulin antiviral agent such as acyclovir
What activities should children at home who have low platelet counts avoid?
activities that could cause injury or bleeding- rising bike, skateboard, roller skates, climbing trees contact sports
What is the most beneficial regimen for the control of nausea/and or vomiting?
administration of an anti-emetic before chemo begins and reg administration at least 24 hours after
When teaching parents about osteosarcoma, the nurse knows instruction has been successful when a parent says that this type of cancer is common in which age-group?
adolescents
A potentially fatal complication of come chemotherapy agents is _____________ and is characterized by ___________________
anaphylaxis; urticaria, angioedema, flushing, rashes, hypotension, N/V, difficulty breathing
Signs and symptoms of brain tumors are directly r/t what two factors
anatomic location size
What is the most common symptom in children with spinal cord compression?
back pain
Why is monitoring the temperature important in post-op care of a child with a brain tumor
because of hyperthermia resulting from surgical intervention in the hypothalamus or brainstem and from some types of anesthesia
What are 2 measures that can lessen the trauma of alopecia?
child can wear surgical cap to help collect shed hair hair can be cut short or shaved
What factors predispose children to cancer?
chromosome abnormalities genetic syndromes immunodeficiency
What supportive measure is administered to prevent side effects caused by low blood counts
colony stimulating factors
The most important reason health-care providers prescribe a combination of antiretroviral drugs to children with HIV is to delay
development of drug resistance
The parent of an infant diagnosed with neuroblastoma asks the nurse what the prognosis is. The nurses best response is
excellent because infants with neuroblastoma have the best prognosis
School-age children with cancer often have body image disturbance r/t hair loss, moon face, or debilitation. Which of the following interventions is (are) most appropriate
encourage them to wear a wig similar too their own hairstyle help them find a "special friend" who understands what they are experiencing
Which of the following is the best method to prevent he spread of infection to an immunosupressed child?
have people wash their hands prior to contact with the child
What are 4 risk factors for tumor lysis syndrome?
high WBC at diagnosis larger tumor burden sensitivity to chemo high proliferative rate
________________ is defined as peripheral white blood cell count greater than 100,000/mm3
hyperleukocytosis
How can hemorrhagic cytitis be prevented?
increase fluids 1 1/2 times recommended amount frequent voiding immediately after feeling the urge administer drug early in the day administration of mesna
Describe characteristics of phantom limb pain
itching, pain, tingling
Why is it important not to palpate the abdomen in a child with Wilm's Tumor?
manipulation of mass may cause dissemination of cancer cells adjacent and to distant sites
What factors have significantly increased the survival rates of children with cancer?
use of multimodal therapy enrollment of large number of children in cooperative group clinical trails or protocols improvements in supportive care