Oncology
General Information:
What are the most common types of pediatric cancer?
leukemia, lymphoma, and brain cancer
General Information:
What are some common tx for pediatric cancer?
surgical, chemotherapy, radiotherapy, clinical trials, biologic response modifiers, bone marrow transplant, blood transplant (stem cell or cord blood)
General Information:
What are some s/sx of chemotherapy?
infection secondary to neutropenia, hemorrhage, anemia, N/V, anorexia, mucosal ulceration (stomatitis), neuropathy, alopecia, mood changes, hemorrhagic cystitis
Leukemia:
What are the s/sx of leukemia?
fever, pallor, anorexia, fatigue, hemorrhage (petechiae, epistaxis, bruising), bone and joint pain, tendencies toward fractures
Lymphoma:
What are the s/sx of hodgkin's lymphoma?
General Information:
What are some known risk factors for pediatric cancer?
ionizing radiation, carcinogenic drugs, immunosuppressive therapy, infections (i.e. epstein barr, etc), race, genetic conditions
- unlike adults, lifestyle does not play a role in childhood cancer
- there is no strong link to environmental factors causing pediatric cancer
General Information:
Chemotherapy organized in phases - what is the induction phase?
complete remission or disappearance of cancer cells
requires hospitalization, limited contact with germs
Leukemia:
What is leukemia? What are the two most common forms found in children?
malignant disease/cancer of the bone marrow and lymphatic system
acute lymphoblastis leukemia (ALL)
acute myelogenous leukemia (AML)
Leukemia:
What are some diagnostic studies used to help diagnose leukemia?
H&P, blood counts (anemia, thrombocytopenia, and neutrpenia, elevated serum uric acid, calcium, potassium, and phosporous levels), bone marrow aspiration (immature and abnormal cells, hypercellular marrow)
Lymphoma:
What are the diagnostic studies and labs used to diagnose hodgkin's lymphoma?
labs: elevated leukocyte count and elevated ESR
General Information:
What labs are initially drawn to identify and/or diagnose cancer?
labs: CBC, chem panel, liver function, coagulation studies, urinalysis
General Information:
Chemotherapy organized in phases - what is the intensification or consolidation phase?
eradicates stray cells
lasts around 6 months
Leukemia:
What is the etiology leukemia?
cause often unknown
possible exposure to infectious agents
genetic factors
exposure to radiation and chemical agents
Leukemia:
What are some ways to manage leukemia?
radiation, chemotherapy, stem cell transplant
Lymphoma:
What is non-hodgkin's lymphoma? What are the s/sx
malignant tumors of lymphoreticular origin, caused by t-cell abnormalities, anterior mediastinum is primary site
s/sx: lymph glands are usually enlarged or nodular, may present with fever and weight loss
General Information:
What are some diagnostic samples you can expect a doctor will order to be collected?
- Lumbar puncture if leukemia, brain tumor, or cancer has metastasized to CNS
- Bone marrow aspiration
- Tissue biopsy
General Information:
Chemotherapy organized in phases - what is the maintenance phase?
preserve remission
may last for several years; life goes on with visits to the hospital/doctor
Leukemia:
What is patho of leukemia?
unrestricted proliferation of immature WBCs leading to decrease of formed (good) elements in the bone marrow blood; immature WBCs complete and deprive other cells of essential nutrients for metabolism
Leukemia:
What nursing interventions would you provide your patient with leukemia?
physical assessment, monitor renal function, monitor dietary intake, nutritious diet, oral care with soft toothbrush, prevention of infection, pain management, safety measures (especially to prevent bleeding)
Lymphoma:
What are some diagnostic and labs used to diagnose non-hodgkin's lymphoma?
diagnostic: bone marrow aspiration, CSR, bone scan, gallium scan, CT and MRI
labs: CBC and additional blood tests for renal and liver function, electrolytes, uric acid, LDH (lactic dehydrogenaze)
General Information:
What are some s/sx for pediatric cancer?
unusual swelling or mass, decreased energy or malaise, paleness, sudden bruising, persistent, localized pain or limping, prolonged, unexplained fever or illness, frequent headaches (often accompanied by vomiting), sudden eye or vision changes, excessive rapid weight loss
General Information:
Chemotherapy organized in phases - what is the reinduction after relapse phase?
bone marrow transplant (hematopoietic stem cell)
*not all are candidates*
Leukemia:
What are some clinical manifestations of leukemia?
anemia from decreased RBCs, infection from decreased neutrophils, bleeding tendencies from decreased platelet production, invasion of bone marrow causes weakening of bone increasing fractures and invasion of the periosteum causes severe pain
Lymphoma:
What is lymphoma?
a neoplastic disease that arises from the lymphoid and hemopoietic systems.
divided into hodgkins (rare before 5 years old) and non-hodgkins
Lymphoma:
What some tx for both lymphomas?
radiation, chemotherapy, HSCT, surgery
hodgkin's better prognosis