basics
What is the incidence of cancer in pediatrics
What are the manifestations of acute lysis syndrome
Hyperuricemia, hypocalcemia, hyperphosphatemia, hyperkalemia, uremia
*acute renal failure or death
What is the difference between ALL and ALM
ALL: occurs in lymphoid cells (B and T cells)
AML: occurs in myeloid cells (RBCs, Platelets, non-lymphocyte WBCs)
Who is at risk for Hodgkin's
15- 19-year-olds
What are the general characteristics of CNS tumors
derived from neural tissue with poor survival rates
What are the different modes of treatment
surgery, chemo, radiation, bone marrow transplant
What are the nursing considerations for caring for a child with cancer
Education on treatment and diagnosis
Treatment administered on schedule with other appropriate doses
Side effects and complications managed/prevented
Coping Skills
QOL maintained, adjustment to illness
* Growth and development maintained during treatment
How do chromosomes affect leukemia
Patients with trisomy 21 have a 20x greater risk of ALL
*Best prognosis: more than 50 chromosomes in the leukemic cells (translocation can affect it)
What are the manifestations of Hodgkin's
Enlarged, firm, nontender, movable nodes in the supraclavicular/cervical area
What are the manifestations of brain tumors
increased head circumference, HA (upon awakening), V, S/S of elevated ICP
What are the four types of bone marrow transplants
Allogenic:
Matched Related Donor
Matched Unrelated Donor
Autologous
Peripheral Stem Cells
Umbilical Cord Blood
What are some common side effects of treatment
Infection
Hemorrhage
Anemia
N/V
Alopecia
Steroid Use
Altered Nutrition
Mucosal Ulceration
What is the diagnosis for leukemia
History, physical, manifestations
Peripheral blood smear (immature leukocytes, low blood counts)
LP to evaluate CNS involvement
Bone marrow aspiration
What are the manifestations of Non-Hodgkin's
Swelling of the face
Abdominal pain/distention/bloating/constipation
Loss of appeteite/diarrhea/potential weight loss
SOB, chest pain, difficulty breathing, coughing
Enlargement of the lymph nodes
Pain surrounding the lymph nodes and vital organs
What is the diagnosis for brain tumors
clinical signs, MRI/CT/EEG/LP, history via surgery
What are the S/S related to the diagnosis
Pain
Fever
Skin Changes (ex: bruising)
Anemia
Abdominal Mass
Swollen Lymph Nodes
What are the health promotion and education
Dental Care
Immunizations: vaccines given 2 weeks before chemotherapy
revacinated/live virus 3 months after chemotherapy has stopped
“Cancer Quackery”: believing something caused the cancer or will treat it
Home Care
Feelings about depression, helplessness, hopelessness
What is the treatment
Chemotherapy: IV and Intrathecal
What is the prognosis for Non-Hodgkin's
85%-95% with limited disease and 70-90% with extensive disease
Where does neuroblastoma develop
adrenal gland from embryonic neural cells
large tumor burden, sensitivity to chemo, high proliferative rate, high WBC
Matched Related Donor: a family member who matches
Matched Unrelated Donor: a non-family member who closely matches
Peripheral Stem Cells: from the patient's own bloodstream and then “given back”
Umbilical Cord Blood: donor umbilical cord
What are the manifestations
Bone Marrow: Anemia, Infection, Hemorrhage, Bone/Joint Pain, Thinning of the Bone, Fractures
Extramedullary Infiltration: Enlarged liver, spleen, lymph nodes
CNS: Leukemic Meningitis
Hypermetabolism: Cellular Starvation
Where does Hodgkin originate from
lymphoid system
What is the diagnostic evaluation of neuroblastoma
Crosses the midline of the abdomen, nontender/firm/irregular mass; urinary frequency or retention
*Objective: locate the primary site and site of metastasis