CARING FOR THE CHILD WITH CANCER I
Match the correct description to the term:
1. MRI 2. CT 3. PET 4. MR HASTE
A. An MRI used when movement can't be controlled
B. Functional/metabolic imaging that uses radioactive tracers
C. Looks at sift tissue, nerves, muscles, and ligaments
D. Looks at bones, trauma, chest, and organs with XR
Match the correct description to the term:
1. MRI C
2. CT D
3. PET B
4. MR HASTE A
List guidelines for neutropenic precautions (3)
List guidelines for preventing infection (3)
List guidelines for preventing hemorrhage and anemia (3)
List guidelines for neutropenic precautions: don't expose to sick people, wash hands, no live plants/flowers, no fresh raw fruits or veggies, private room with door closed, mask for transport and high-risk areas
List guidelines for preventing infection: great oral care, avoid large crowds, hand hygiene for the whole family, no live vaccines, education on signs of infection
List guidelines for preventing hemorrhage and anemia: avoid rectal temps and meds, avoid IM injections and lumbar punctures, pressure dressing after bone marrow aspiration, avoid trauma, acetaminophen instead of NSAID for pain, limit blood draws, encourage high iron diet, and assess for bleeding
Brain tumor diagnosis includes CT, ____, and MRI to view extent and _____ of tumor, ______ to visualize blood flow through the brain, _____ to evaluate CSF, and biopsy of the tumor for diagnosis.
Treatment for brain tumors includes _____ or _____ of tumor. Radiation is not used in children <__ years old due to effects on developing brain. Chemo and HSCT are used less often.
Brain tumor diagnosis includes CT, PET, and MRI to view extent and location of tumor, angiogram to visualize blood flow through the brain, LP to evaluate CSF, and biopsy of the tumor for diagnosis.
Treatment for brain tumors includes ressection or debulking of tumor. Radiation is not used in children <3 years old due to effects on developing brain. Chemo and HSCT are used less often.
Clinical manifestations of osteosarcoma are _____ bone pain, limpness, limited _ _ _, erythema, swelling, warmth, mass may or may not be visible.
Treatment includes chemotherapy and _______, _______ is not effective.
Clinical manifestations of osteosarcoma are dull bone pain, limpness, limited ROM, erythema, swelling, warmth, mass that may or may not be visible.
Treatment includes chemotherapy and surgery, radiation is not effective.
Rhabdomyosarcomas are a highly malignant soft tissue tumor that arises from embryonic ________ cells (striated muscle). Most commonly occurs in the _____ and neck, GU tract, abdomen, and extremities. May use ______ , radiation, and ______ for treatment.
Rhabdomyosarcomas are a highly malignant soft tissue tumor that arises from embryonic mesenchymal cells (striated muscle). Most commonly occurs in the head and neck, GU tract, abdomen, and the extremities. May use chemo, radiation, and surgery for treatment.
Common lab tests for pediatric cancers:
1. AFP (___________): elevated in Hodgkin lymphoma
2. urine _________: elevated in neuroblastoma, collected with ________ test
3. _ _ _: detects issues with blood cells, a common characteristic of cancer
Common lab tests for pediatric cancers:
1. AFP (a-fetoprotein): elevated in Hodgkin lymphoma
2. urine catecholamines: elevated in neuroblastoma, collected with 24-hour test
3. CBC: detects issues with blood cells, a common characteristic of cancer
Determine whether the following statements are true or false:
1. It is very important to double-check the code status
2. The nurse should guide the family by telling them what to do
3. The nurse should discourage siblings from being at the child's bedside
4. The nursing assistant should push the child to eat to provide adequate nutritional support
Determine whether the following statements are true or false:
1. It is very important to double-check the code status: TRUE
2. The nurse should guide the family by telling them what to do: FALSE- the nurse should include the family and ask them what they want as often as possible
3. The nurse should discourage siblings from being at the child's bedside: FALSE- encourage visitation as appropriate
4. The NA should push the child to eat to provide adequate nutritional support: FALSE- the NA should provide small frequent meals and avoid coaxing
Acute myelogenous leukemia affects the ______ progenitor, causing myeloblasts (immature WBC) to rapidly grow and is _____ resistant to treatment. Requires ______ and may require _____, especially if relapse occurs.
Acute myelogenous leukemia affects the myeloid progenitor, causing myeloblasts (immature WBC) to rapidly grow and is more resistant to treatment. Requires chemo and may require HSCT, especially if relapse occurs.
A _________ is a solid extracranial (outside the head) tumor that is only found in children and arises from the embryonic neural crest cells.
Stage __ can be completely resected. All other stages require _____. Stage __ is metastasis to other sites, including bone, while stage __ does NOT include bone
A neuroblastoma is a solid extracranial (outside the head) tumor that is only found in children and arises from the embryonic neural crest cells.
Stage 1 can be completely resected. All other stages require chemo. Stage 4 is metastasis to other sites, including bone, while stage 4-S does NOT include bone
HVA and VMA are elevated in the 24-hour urine collection for patients who have a _________ but not elevated in patients who have a _______.
HVA and VMA are elevated in the 24-hour urine collection for patients who have a neuroblastoma but not elevated in patients who have a Wilms tumor.
Staging classifications:
__ (_____)- size and extent of primary ______
__ (_____)- how many ________ involved
__ (_____)- has it spread to secondary areas?
Staging classifications:
T (tumor)- size and extent of primary tumor
N (lymph)- how many lymph nodes involved
M (metastasis)- has it spread to secondary areas?
Leukemia occurs when hematopoietic stem cells in the bone marrow produce immature, abnormally functioning _______. These bad cells increase the risk for ______ and take the place of ______ and ______ over time.
Leukemia occurs when hematopoietic stem cells in the bone marrow produce immature, abnormally functioning WBCs. These bad cells increase the risk for infection and take the place of RBCs and PLTs over time.
____ _____ brain tumors are localized and have a better prognosis
____ _____ brain tumors are invasive and harder to resect
Signs of a brain tumor include: pressure on surrounding areas of the brain, signs of increased ________ _______, intellectual delays, hydrocephalus if CSF is obstructed, and ______
Low-grade brain tumors are localized and have a better prognosis
High-grade brain tumors are invasive and harder to resect
Signs of a brain tumor include: pressure on surrounding areas of the brain, signs of increased intracranial pressure, intellectual delays, hydrocephalus if CSF is obstructed, and headache
An _______ is a bone cancer that forms in the embryonic mesenchymal tissue and occurs commonly in the _____ bones, such as, the distal _____, humerus, and ______ tibia.
An osteosarcoma is a bone cancer that forms in the embryonic mesenchymal tissue and occurs commonly in the long bones, such as the distal femur, humerus, and proximal tibia.
Wilms tumor is most commonly a _____ tumor that causes painless ______, unilateral mass, and hypertension. NO _______ of the abdomen after initial diagnosis. Treatment includes _________ and chemo/radiation.
Wilms tumor is most commonly a renal tumor that causes painless hematuria, a unilateral mass, and hypertension. NO palpation of the abdomen after initial diagnosis. Treatment includes nephrectomy and chemo/radiation.
Benefits of having a port for chemotherapy administration include: (2)
How to prevent infection: (2)
Benefits of having a port for chemotherapy administration include: can't be pulled out as easily, can be de-accessed when not in use, can be used for harsher meds that smaller veins can't handle, can be used for blood draws, allows a more normal life for the child
How to prevent infection: de-access when not in use, limit access by consolidating care, regular dressing changes, CHG baths, keep away from diapers and g-tubes, make sure its not hanging on the floor or in the child's mouth, scrub access site for 15 seconds and let dry before using, wear gloves, sterile cap changes and tubing changes per protocol
3 out of 4 leukemia cases are classified as _____ ________ leukemia, in which the cells infiltrate the ______ and joints- can also enter CSF and lymph. Diagnosed with ________ aspiration and affects _______ progenitor cells, which create immature, weak, and fragile lymphoblasts that will replace other important blood cells over time.
3 out of 4 leukemia cases are classified as acute lymphoblastic leukemia, in which the cells infiltrate the bones and joints and can also enter CSF and lymph. Diagnosed with bone marrow aspiration and affects lymphoid progenitor cells, which create immature, weak, and fragile lymphoblasts that will replace other important blood cells over time.
Nursing management after a brain tumor surgery includes:
1. _____ management
2. _____ (monitor for ______ after anesthesia)
3. _____ assessments
4. positioning important (usually keep <__ degrees)
5. Drain management (call provider if drain _____) or suddenly changes color)
Nursing management after a brain tumor surgery includes:
1. pain management (may need narcotics)
2. vitals (monitor for hyperthermia after anesthesia)
3. neurological assessments (frequent and thorough)
4. positioning important (usually keep <30 degrees)
5. Drain management (call provider if drain stops putting out) or suddenly changes color)
The first sign of a neuroblastoma often noticed by parents is ______ of abdomen, tumor is _____ and immoble, symptoms depend on where tumor lies.
The 24-hour urine collection will reveal elevated ________ acid (HVA) and ________ acid (VMA) in patients with neuroblastomas.
The first sign of a neuroblastoma often noticed by parents is swelling of abdomen, tumor is fixed and immobile, and symptoms depend on where tumor lies.
The 24-hour urine collection will reveal elevated homovanillic acid (HVA) and vanillylmandelic acid (VMA) in patients with neuroblastomas.
_________ is a congenital highly malignant tumor from embryonic retinal cells, with _______ being the number one presenting sign (also referred to as cat eye reflex). The second most common sign is _______.
Retinoblastoma is a congenital highly malignant tumor from embryonic retinal cells, with leukocoria being the number one presenting sign (also referred to as cat eye reflex). The second most common sign is strabismus.
Granulocyte colony-stimulating factor is given to children receiving chemotherapy to increase _____ growth
All drugs that cause bone marrow suppression have a point of _____ in which neutrophil count is the lowest
Granulocyte colony-stimulating factor is given to children receiving chemotherapy to increase WBC growth
All drugs that cause bone marrow suppression have a point of Nadir in which neutrophil count is the lowest
Management of complications of ALL include: _____ transfusions, _____ control, and _______ precautions
Treatment of ALL includes: ______ (in stages) or _____ if relapse or nonresponsive to chemo
Management of complications of ALL include: blood transfusions, pain control, and bleeding precautions
Treatment of ALL includes: chemo (in stages) or HSCT if relapse or nonresponsive to chemo
**DAILY DOUBLE**
Match the term to the correct definition:
1. medullablastoma, 2. brainstem glioma, 3. ependymoma, 4. astrocytoma
A. fast-growing, invasive, highly malignant, in the cerebellum
B. aggressive, slow growing, hard to resect, resistant to chemotherapy, can impact cranial nerves
C. slow growing, in the cerebellum, thalamus, hypothalamus, and cerebral hemisphere
D. speed growth varies, can cause hydrocephalus which prompts early detection, located in ventricle tissue
**DAILY DOUBLE**
Match the term to the correct definition:
1. medullablastoma A
2. brainstem glioma B
3. ependymoma D
4. astrocytoma C
_____ Sarcoma is a round cell tumor of the bone usually involving the diaphyseal (_____) portion of the long bones and is highly malignant. Treatment includes excision of tumor, ______, and ______.
Ewing Sarcoma is a round cell tumor of the bone usually involving the diaphyseal (shaft) portion of the long bones and is highly malignant. Treatment includes excision of tumor, chemo, and radiation.
Treatment of retinoblastoma includes radiation, chemo, _____ surgery, cryotherapy, photocoagulation, and enucleation (____ removal). The nurse should teach parents how to remove, clean, and replace _______ ______.
Treatment of retinoblastoma includes radiation, chemo, laser surgery, cryotherapy, photocoagulation, and enucleation (eye removal). The nurse should teach parents how to remove, clean, and replace prosthetic eye.