chapter 46 prepU
A nurse is providing care for a child with disseminated intravascular coagulation (DIC). What would alert the nurse to possible neurologic compromise?
*Widely fluctuating blood pressure *unequal pupil size
Recommended iron intake for children 1 to 10.
10 mg
Recommended iron intake for boys 11 to 18
12 mg
Recommended iron intake for girls 11 to 18
15 mg
Recommended iron intake for children 0 to 6 months
6 mg
The nurse performing a physical assessment of a client checks for signs of malignancies. Which may indicate a soft tissue mass?
Cranium masses Swelling around eyes Drainage from ear
indicative of osteosarcoma
Dull bone pain in the proximal tibia
When providing care for a child immediately after a bone marrow aspiration, which nursing action is priority?
Monitor the site dressing and vital signs.
For pernicious anemia, how often are the the vit B12 shots are given?
Monthly, for the rest of their life.
frequent effect of antimetabolic drugs
Mucositis or ulcers of the gum line and mucous membranes of the mouth
while child is receiving chemotherapy, what type of medication parents shouldn't give to the kid?
NSAIDs because it may interfere with blood coagulation
Henoch-Schonlein syndrome lab results
Normal platelet count and elevated sedimentation rate, elevated white blood cell count, and elevated eosinophil count.
indicative of rhabdomyosarcoma
An asymptomatic mass on the upper back
The nurse will use a special needle to start intravenous (IV) fluids through which central venous access device?
An implanted port
Dimercaprol, Edentate calcium disodium and Succimer are indicated for what?
Blood lead levels greater than 45 mcg/dL. It removes lead from soft tissues and bone, allowing for its excretion via the renal system.
Which mechanism is central to cancers in children?
Cellular growth
The nurse is caring for a child who had a stem cell transplant and is being monitored for engraftment. Which nursing action is priority?
Ensure neutropenic precautions are in place.
A nurse is caring for a newborn whose screening test result indicates the possibility of sickle cell anemia (SCA) or sickle cell trait. The nurse would expect the test result to be confirmed by which lab tests?
Hemoglobin electrophoresis
A child with leukemia is receiving methotrexate for therapy. Which nursing diagnosis should the nurse use to best guide this child's care at this time?
Impaired oral mucous membrane related to effects of chemotherapy.
Which diagnostic test result is only present in Hodgkin disease?
Reed Sternberg cells
what can the skin of a child with Kawasakii disease look like?
Rush on trunk and extremities
Veno-occlusive disease manifastation
Sudden, unexpected weight gain, thrombocytopenia, jaundice, hepatomegaly, right upper quadrant pain, ascites and encephalopathy.
A school-aged child is scheduled for a bone marrow aspiration to confirm the diagnosis of aplastic anemia. What should the nurse instruct the child about this procedure?
The child will have to lie on the stomach for the procedure.
what does graft-versus-host disease involves?
The development of a maculopapular rash on the palmar and plantar surfaces of the hand and feet evolving into erythematous rash over most of body (ranging from slight redness of the skin to complete skin desquamation)
what is the primary intervention for beta-thalassemia
a chronic transfusion program of packed red blood cells with iron chelation. - facilitates adequate oxygenation of body tissues and practically eliminates all symptoms.
Stage I tumor
a tumor that has not extended into the surrounding tissue so can be completely removed surgically
How does the skin of a child with thalassemia look like?
bronze-colored or jaundiced
signs of Disseminated intravascular coagulation (DIC)
bruising, petechiae and ecchymoses.
A child with hemophilia may present with what?
brused areas on the skin
Stage III tumor
cancer cells have spread to local lymph nodes
The nurse will select which meal as the best choice for a child with iron-deficiency anemia?
cheeseburger, broccoli, and fresh strawberries
A child is sent to pediatric intensive care following surgery for a brain tumor. Which prescription would the nurse question?
elevate head of bed 90 degrees
signs of graft failure
fever, infection and a decrease in blood counts
idiopathic thrombocytopenic purpura is marked by what?
hemorrhagic rash on the lower extremities.
what is Deferasirox for
indicated for iron toxicity. It binds with iron, which is removed via the kidneys.
Ewing sarcoma
may result in swelling and erythema at the tumor site. Common sites are chest wall, pelvis, vertebrae, and long bone diaphyses.
what happens during the observation phase
therapy has ended and the child is followed up for recurrent disease or late effects of treatment.
Stage II tumor
there is some local spread but the chance for complete surgical removal is good
In the consolidation phase, intensive therapy is given for what
to destroy remaining cancer cells.
during induction, the initial phase, intensive therapy is given for what?
to kill enough cancerous cells to induce a remission
What happens during the maintenance phase
treatment is continued to destroy any residual cancer cells.
rhabdomyosarcoma
tumor of the muscle
Stage IV tumor
tumors that have spread systemically (metastasis).
pernicious anemia
vitamin B12 deficiency and have symptoms such as pallor, irritability, beefy red tongue, and diarrhea.
