unit 3
A 4-year-old child with acute lymphocytic leukemia has been admitted to the hospital in relapse. The priority concern is infection due to immunosuppression. Which interventions should the nurse include in the plan of care?
Perform oral hygiene four times a day.
The nurse is monitoring the laboratory values of a child with leukemia who is receiving chemotherapy. The nurse prepares to implement bleeding precautions if the child becomes thrombocytopenic and the platelet count is less than which value?
20,000 mm3
A 4-year-old child is hospitalized with a suspected diagnosis of Wilms' tumor. The nurse reviews the plan of care and should question which intervention that is written in the plan?
Palpate the abdomen for a mass.
The nurse reinforces instructions to the parents of a child with leukemia regarding measures related to monitoring for infection. Which statement by the parents indicates the need for further teaching?
"I need to take my child's rectal temperature daily."
The nurse is providing discharge instructions to the parents of a 14-year-old child who is undergoing radiation for Hodgkin's disease. Which statement by a parent indicates the need for further teaching?
"I will need to keep my child's skin from flaking, so we will be allowing showers every 2 or 3 days."
The nursing instructor asks a student nurse to describe osteogenic sarcoma. Which statement by the student indicates the need to further research the disease?
"The child does not experience pain at the primary tumor site."
A 6-year-old child has just been diagnosed with localized Hodgkin's disease, and chemotherapy is planned to begin immediately. The mother of the child asks the nurse about radiation therapy because it was not prescribed as a part of treatment. Which is the most appropriateresponse to the mother?
"The child is too young to have radiation therapy."
The nurse is assessing a pediatric client with a diagnosis of retinoblastoma. The nurse assesses for which most common clinical finding for a child with this diagnosis?
Cat's-eye reflex
A 4-year-old child is admitted to the hospital with suspected acute lymphocytic leukemia (ALL). The nurse should prepare for which diagnostic study that can confirm this diagnosis?
A bone marrow biopsy
The nurse is assisting in preparing to care for a child with a brain tumor who will be returning from the recovery room following debulking of the tumor. Which item should the nurse place at the bedside in preparation for the child's return from surgery?
A cooling blanket
The nurse is assigned to care for a child with a diagnosis of Wilms' tumor. The child's mother asks the nurse what kind of tumor this is. What is the best response by the nurse?
A nephroblastoma
A preliminary diagnosis is made for a child with acute lymphoblastic leukemia (ALL). In reviewing the complete blood cell count (CBC) of the child, the nurse should expect to find which?
An erythrocyte (red blood cell) count of 2 cells in 1 mL of peripheral blood
The nurse has reviewed the primary health care provider's prescriptions for a child suspected of a diagnosis of neuroblastoma and is preparing to implement diagnostic procedures that will confirm the diagnosis. The nurse prepares to do which?
Collect a 24-hour urine sample.
The nurse monitors a 5-year-old child admitted to the hospital for a neuroblastoma for signs and symptoms related to the location of the tumor in the adrenal gland. Which descriptions would the nurse expect to be documented in the child's record specific to this tumor? Select all that apply.
Firm, nontender, irregular mass in the abdomen Urinary frequency or retention from compression on the bladder
The nurse is preparing to care for a child who received an allogenic bone marrow transplant (BMT). The nurse understands that which is the priority concern?
Infection
The nurse is asked to prepare for the admission of a child to the pediatric unit with a diagnosis of Wilms' tumor. The nurse assists in developing a plan of care for the child and suggests including which intervention in the plan of care?
Inspect the urine for the presence of hematuria at each voiding.
The nurse is caring for a 9-year-old child with leukemia who is hospitalized for the administration of chemotherapy. The nurse monitors the child for central nervous system (CNS) involvement by checking which response?
Level of consciousness (LOC)
The nurse is monitoring for bleeding in a child after surgery to remove a brain tumor. The nurse checks the head dressing for the presence of blood and notes a colorless drainage on the back of the dressing. Which nursing action is appropriate?
Notify the registered nurse (RN).
A 6-year-old child with leukemia is hospitalized and is receiving combination chemotherapy. Laboratory results indicate that the child is neutropenic, and the nurse prepares to implement protective isolation procedures. Which interventions should the nurse initiate? Select all that apply.
Place the child on a low-bacteria diet. Change dressings using sterile technique. Perform meticulous hand washing before caring for the child.
The nurse is caring for a child with osteosarcoma following amputation of the left lower limb. The child is continually complaining of aching and cramping in the missing limb. Which action should the nurse take?
Reassure the child that this is a temporary condition.
A nursing student is asked to discuss the pathophysiology related to childhood leukemia during a clinical conference and reviews the planned presentation with the nursing instructor. The nursing instructor advises the student to review the disorder before the clinical conference if the student states that which is associated with this type of cancer?
Reed-Sternberg cells are found on biopsy.
A 12-year-old child is seen in the clinic, and a diagnosis of Hodgkin's disease is suspected. Several diagnostic studies are performed to determine the presence of this disease. When evaluating the diagnostic results, the nurse should expect to note which evidence if this child has Hodgkin's disease?
The presence of Reed-Sternberg cells
The nursing instructor assigns a student nurse to present a clinical conference to the student group about brain tumors in children. Which statement by the student is accurate about brain tumors in children?
The significant symptoms are headaches and morning vomiting.
