week 10 prepU 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."
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."
The nurse is preparing to administer epoetin alpha to a child undergoing chemotherapy. What consideration(s) will the nurse take into account when administering this therapy? Select all that apply.
1,2
The nurse is performing chemotherapy teaching for a child who is about to begin treatment for cancer with the child's parents. What will the nurse include in the teaching? Select all that apply.
1,2,3
An adolescent receiving chemotherapy has lost all hair and is sad about self-image. Which action should the nurse take to support this adolescent and involve the client in decision making?
Encourage the adolescent to select hats or wigs to fit one's personality.
The pediatric nurse examines the radiographs of a client that indicate lesions on the bone. This finding is indicative of:
Ewing sarcoma.
The nurse is instructing a childhood cancer survivor, now 20 years old, on the need to inform future health care providers of their prior disease and treatments. Which rationale is included in the instruction?
It is important to monitor for late effects.
The nurse is describing the phases of treatment to a child who was diagnosed with leukemia and his parents. How would the nurse describe the induction stage?
Rapid promotion of complete remission
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.
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.
When reviewing information about the incidence of the various types of childhood cancer, nursing students demonstrate understanding of the information when they identify which type as having the highest incidence?
Acute lymphoblastic leukemia (ALL)
Parents of a 10-year-old have just been informed that their child has stage III cancer. They ask the nurse what this means. What is the nurse's best response?
"The cancer cells have spread to the lymph nodes."
A 3-year-old who has been attending preschool has been diagnosed with leukemia. The caregivers of this child ask the nurse what they can do to help their child feel secure. Which recommendation could the nurse make to these caregivers that would be helpful in making the child feel secure?
"Let your child continue to attend preschool as much as possible."
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 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.
1,2,3,6
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 nurse is preparing to send a child with cancer for a radiation treatment. Which medication should the nurse provide to premedicate the child for this procedure?
Antiemetic
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
A nursing student compares and contrasts childhood and adult cancers. Which statement does so accurately?
Children's cancers, unlike those of adults, often are detected accidentally, not through screening.
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.
When providing care to a dying child and his family, which would be most important?
Focusing on the family as the unit of care.
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.
The nurse is caring for a child who is undergoing a stem cell transplant. What information will the nurse include in the child's postoperative plan of care?
Monitoring for severe diarrhea and maculopapular rash.
The nurse is caring for a 5-year-old boy undergoing radiation treatment for a neuroblastoma. Which nursing diagnosis would be most applicable for this child?
Impaired skin integrity related to desquamation from cellular destruction
The nurse is caring for an 8-year-old newly diagnosed cancer client. Which of the following nursing interventions is the most helpful for the client at this time?
Initiate palliative care for this client now.
A 15-year-old boy has been diagnosed with an osteosarcoma of the distal femur. He also demonstrates a chronic cough, dyspnea, and chest pain, along with chronic leg pain. Based on these findings, the nurse should suspect metastasis to which body area?
Lungs
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.
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.
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
The nurse is caring for a child who is receiving peripheral intravenous (IV) chemotherapy. The child tells the nurse that the IV "hurts." The nurse finds that the insertion site is reddened and edematous. Which action will the nurse take?
Stop the IV chemotherapy from infusing.
The nurse is assessing a 3-year-old boy whose parents brought him to the clinic when they noticed that the right side of his abdomen was swollen. What finding would suggest this child has a neuroblastoma?
The parents report that their son is vomiting and not eating well.
The health care provider prescribes an alkylating agent as part of a child's chemotherapy regimen. When explaining this classification of drug to the child and parents, which information would the nurse integrate into the explanation?
They are cell cycle-nonspecific, destroying both resting and dividing cells.
Wilms tumor is suspected in a 5-year-old child. Which action would be avoided?
abdominal palpation
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
A nurse is caring for a terminally ill 7-year-old child who is hospitalized and is wishing to go home. What type of referral will allow the child to receive care at home?
hospice care
A child with cancer is dying and in hospice care. When developing the plan of care, which intervention should the nurse include as the primary focus?
keeping the child pain-free
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
An experienced nurse is orienting a new nurse to the oncology unit. Which action by the new nurse would require intervention?
pouring unused chemotherapy medicine into a sink drain
The nurse is working with a family whose daughter is dying of a brain tumor. When addressing the situation with the child's sibling, the nurse should prioritize what consideration?
the sibling's stages of growth and development
A nurse is reviewing the laboratory test results of a 3-year-old child diagnosed with acute lymphoblastic leukemia (ALL). Which result would the nurse likely find?
thrombocytopenia
