cancer
Define neoplastic
Cells that proliferate (divide) abnormally
What does childhood cancer normally effect
Tissues
TNM classification
Tumor
Lymph
Mets
"Staging" of cancer
Usually the higher the stage the poorer prognosis and higher probability of mets
Children with leukemia are at a higher risk for what and why
Infection, immature WBC's
Name 3 ways to prevent hemorrhage and anemia during chemo
Avoid rectal temps/meds
Avoid IM injections/LP
Pressure dressing after bone marrow aspiration
Use Tylenol instead of NSAIDS
Limit blood draws
Encourage diet with adequate iron
PET scan diet
24 hours before- no strenuous exercise, low carb and no sugar
NPO 4-6 hours before
Name 3 ways to prevent infection during chemo
Private room
Great oral care
Avoid large crowds
Hand hygiene for entire family
No live vaccines
Mask
No fresh flowers, plants
No raw fruits/veggies
What is normally the first sign of GVHD
Maculopapular rash
Is acute lymphoblastic leukemia or acute myelogenous leukemia harder to treat
AML
Wilms tumor s/s (name 2)
Painless hematuria, mass on one side of abd (usually unilateral), hypertension
Brain tumor post-op care (list everything you can think of)
Careful with narcotics
Monitor for hyperthermia
Frequent and through neuro checks
Keep flat or <30 degrees
May have drain, call with drastic changes in color or amount
Use SPF/protect from sun
Do not wash mark off
Use gentle soap and water to clean
No rubbing of the area
Avoid scented products
Avoid tape in radiation area
Use topical for itching
What med is used to prevent tumor lysis syndrome
Allopurinol (inhibits uric acid production)
Name 3 assessment findings with cancer
Masses
Pain
General fatigue
Pallor
Sudden weight loss
Sudden decline in milestones
HA with vomiting
Changes to vision
Gait changes
Brusing or bleeding without cause
What is maintenance phase of chemo and how long is it
Eliminate all residual leukemic cells
2-3 years
Name 3 differences between neuroblastoma and wilms tumor
Neuroblastoma- on adrenal glands, usually fixed and immobile, can be palpated
Wilms- on kidney, may be displaced, can NOT be palpated (will cause mets)
Ewings
Osteosarcoma is radioresistant
What is the consolidation phase of chemo and how long is it
Strengthen remission, reduce leukemic cell burden
Vaires
What is the number one presenting sign of retinoblastoma
Leukocoria
What urine labs are tested with neuroblastoma
24 hour collection of homovanillic acid (HVA) and vanillylmandelic acid (VMA) both increased
What is the induction phase of chemo and how long is it
Rapid induction of complete remission
3-4 weeks
What is tumor lysis syndrome
The tumor lysis syndrome occurs when tumor cells release their contents into the bloodstream, either spontaneously or in response to therapy, leading to the characteristic findings of hyperuricemia, hyperkalemia, hyperphosphatemia, and hypocalcemia
What is retinoblastoma
A congenital highly malignant tumor from embryonic retinal cells
What should be avoided with Wilms tumor
NSAIDS, palpation, and contact sports