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