Prep U Peds chapter 26

The health care provider has just informed the parents of a 3-year-old that their child has leukemia. The mother begins crying and tells the nurse she does not want her baby to die. What is the nurse's best response?

"I know this is scary, but leukemia has a high cure rate in children these days."

A nursing student asks one of the nurses on the unit, "What exactly is palliative care?" Which response by the nurse would be most accurate?

"Palliative care can coexist with other treatment that is focused on a cure, stabilization of a disease process, or prolongation of life."

The nurse is speaking to the mother of a dying child about the best ways to manage pain and discomfort. Which is the best response by the nurse?

"We will provide pain medication around the clock to help prevent recurrence or escalation of pain."

A nurse is caring for a child with Hodgkin disease who is in the induction phase of a chemotherapy regimen. The nurse explains to the parents that the goal of this phase is to:

A nurse is caring for a child with Hodgkin disease who is in the induction phase of a chemotherapy regimen. The nurse explains to the parents that the goal of this phase is to:

The parents of a child with a malignancy disagree with each other about the treatment plan, then express frustration at the staff for not answering call lights quickly enough. Which nursing intervention will best address their needs?

Accept the parents' anger and respond with empathy and acceptance.

The toddler with a cancer diagnosis is seen for a well-child checkup. Which health maintenance activity will the nurse exclude?

Administering the measles, mumps, rubella (MMR) vaccine

A 4-year-old child diagnosed with Wilms tumor is admitted for surgery. What information would be most important for the nurse to include in the child's preoperative plan of care?

Avoiding further abdominal palpation

How can the nurse most simply describe for distressed parents a rhabdomyosarcoma that has been found in their 5-year-old?

Call it a tumor of muscle tissue

The nurse is providing care to a child who is nearing death. Which of the following would be most important for the nurse to keep in mind when communicating with the child?

Communication can be key in helping to meet the psychological needs of the dying child.

The family of a terminally ill client is asking about the benefits of hospice care. Which statement by the nurse provides accurate information?

Hospice is designed to meet the individual client's needs.

Nursing students are reviewing information about childhood cancers. They demonstrate understanding of the information when they identify what as the most frequent type?

Leukemia

The nurse is assessing a 3-year-old boy whose mother reports that he is listless and has been having trouble swallowing. Which finding suggests the child may have a brain tumor?

Observation reveals nystagmus and head tilt.

A nurse is providing teaching to a child receiving chemotherapy and the parents. The nurse determines that the teaching was successful when the parents state that they will contact the primary health care provider if which occurs?

The child has redness or swelling at the central venous access site.

A nurse is caring for a teenager who is in the end stage of cancer. Which of the following nursing interventions provides self-esteem and self-worth to the teen?

allowing the teenager to completely participate in decisions

A child with cancer is receiving vincristine. It is most important to observe this child for which of the following side effects?

constipation

The nurse is monitoring a 6-year-old child on chemotherapy for signs and symptoms of internal bleeding. Which finding(s) requires follow up by the nurse? Select all that apply.

fatigue weakness

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

Children with acute lymphoblastic leukemia (ALL) may need periodic lumbar punctures. The nurse would teach the parent that this is done to assess for:

leukemic cells.

The nurse is preparing a presentation for a parent group about childhood cancers, focusing on brain tumors in children younger than 14 years. Which type of tumor will the nurse include as one of the most common types in that age group?

medulloblastoma

Before administering a chemotherapeutic drug to a 12-year-old child with leukemia, the nurse confirms appropriate medication dosage by which method?

obtaining data to calculate the child's body surface area

The nurse is reviewing the medical record of a child diagnosed with Hodgkin lymphoma at the asymptomatic stage. Which would the nurse identify as typically the first sign reported by the child?

painless, enlarged lymph node

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

The nurse is preparing a child for diagnostic testing because neuroblastoma is suspected. The nurse would most likely prepare the child for which testing?

urine catecholamines VMA, HVA

The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of:

Ewing sarcoma.

A client and family have just been told that the child has a malignant brain tumor that appears inoperable. Which nursing intervention would be most beneficial to this family and client?

Explain that death is possible and offer curative and palliative care together.

When providing care to a dying child and his family, which would be most important?

Focusing on the family as the unit of care.

What is the priority action the nurse should take when caring for a child newly diagnosed with Wilms tumor (nephroblastoma)?

Protect the abdomen from manipulation.

A child is undergoing a series of diagnostic tests for a suspected malignancy. Which diagnostic test result is only present in Hodgkin disease?

Reed-Sternberg cells

A 5-year-old client has been diagnosed with leukemia and is currently on chemotherapy and radiation. The child is having difficulty due to mucositis. Which is the most appropriate nursing diagnosis for this child?

Risk for imbalanced nutrition, less than body requirements, related to inflammation

A child with acute lymphoblastic leukemia (ALL) is starting treatment with methotrexate in an attempt to eradicate the leukemic cells. Which stage of therapy is the child undergoing?

induction stage

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

The school nurse is providing information to parents of adolescents about prevention of cervical cancer. Which information is included in the teaching?

vaccine against human papillomavirus (HPV)