Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NUR 440 Exam 3 > Child with Cancer > Flashcards

Child with Cancer Flashcards

1
Q

Most common childhood cancer

A

Leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What Causes Cancer

A

Carcinogens
Immune Disorders
Chromosome abnormality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

History Assessment

A 
Presenting illness
Previous illnesses
Family history or cancer
Present state of health of immediate family
Developmental milestones
Psychosocial or family concerns
ASK ABOUT ANY DEATH UNDER 50
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Cardinal Symptoms of Cancer

A 
Unusual mass or swelling
Unexplained paleness or loss of energy
Sudden tendency to bruise
Persistent, localized pain or limping 
Prolonged unexplained fever or illness
Frequent headaches and vomiting
Eye or vision changes
Excessive and rapid weight loss
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Staging

A

Diagnoses of cancer
Type, severity and spread of cancer cells at the time of diagnosis
All tests are painful – use sedation
Diagnosed at a later stage – poor prognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

CBC with ANC

A

CBC with Absolute Neutrophil count
Degree of anemia and infection
<500 IS CRITICAL
**Leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Electrolyte Panel

A

Type of diagnostic test
Look at renal and liver function
Disruption of healthy cells
Elevated uric acid in leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tumor Markers

A

Type of diagnostic test
Metabolities or part of the cancer cells detected in serum or urine
**Neuroblastoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Lumbar Puncture

A

Type of diagnostic test
Conscious sedation
Lie still and flat after – to decrease spinal headahce
Monitor site for bleeding and infection!
Routinely used for metastasis in the brain for leukemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Bone Marrow Aspirate

A

Type of diagnostic test
Conscious sedation
Prep children! They will not feel it but could be awake
Large band aide on their hip
Monitor for bleeding
Detective test for leukemia and solid tumors
Aspirate the bone marrow – fatty not red

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

CT and MRI

A

Type of diagnostic test
CT, MRI and PET
Being used to visualize tumors and begin the diagnostic
Do not hurt but you have to stay still

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Treatment: Surgery

A

Used to remove all the tumor or debulk it

Most successful when the tumor is encapsulated and has not spread

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Treatment: Radiation Therapy

A

Curative or relief of symptoms by shrinking the tumor
Radiation sickness is the anorexia and NV that occurs most with GI irradiation
Antiemetic prior to procedure may help
Skin is tender!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Treatment: Chemotherapy

A

Primary form of treatment
Need a central line – lessons the chance of skin or tissue damage and irritation
Anticipate pt symptoms!!
Look at ANC counts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Treatment: Biotherapy

A

Use remodeled antibiodies to target cancer cells only

Limits side effects of the therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Treatment: Bone Marrow & Stem Cell Transplant

A

Treatment choice for some cancers (Leukemia)
Total body irradiation and intensive chemo to kill all cancer cells and all bone marrow cells
Need a good match!!
At risk for Graft VS. Host
Use cord blood for hematopoietic stem cell is on the rise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Leukemia

A

Most common childhood cancer
Disease of the bone marrow and lymphatic system
Unrestricted proliferation of immature WBC’s in the blood
AML and ALL are the most common
ALL has a better prognosis
Can infiltrate CNS via blood or lymph system – neuro signs and symptoms
Frequent LPs to monitor for cells in the CSF

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Leukemia Goals

A

Remission
Considered “cured” if no cancer cells after 5 years
Harder to achieve remission if cancer cells reappear within 5 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Leukemia Treatment

A

Primary chemo, some radiation

Bone marrow and stem cell transplant to consider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Hodgikn’s Lymphoma

A

Neoplastic disease originating in the lymphoid system and primarily affects the lymph nodes
Spread to spleen, liver, bone marrow, lungs and eventually the CNS
High degree of metastasis because next to blood vessels
Look into sperm banking and ovarian tissue

21
Q

Hodgkin’s Lymphoma Symptoms

A

Anorexia, malaise, night sweats, weight loss, fever, one painless cervical lymph node
+ Reed Sternberg Cells

22
Q

Hodgkin’s Lymphoma Treatment

A

DX: Lymph node biopsy
Chemo and radiation
Possible bone marrow transplant

23
Q

Non- Hodgkin’s Lymphoma

A

Malignant disorder of the lymporectiular system
Caused by T-cell abnormalities
Highly aggressive and malignant cancer
Fever, pallor, weigh loss, new onset of respiratory distress, recent transplant
HIV – high risk

24
Q

Non- Hodgkin’s Lymphoma Treatment

A

Diagnosed at a later stage– through biopsy
More treatment over a longer period of time
Aggressive chemo and radiation per protocol
6-24 months of drugs
Intrathecal chemo due to high rate of CNS metastasis
Symptom management
Treat patient and family as a whole

25
Q

Brain Tumors

A 
Astryocytoma, Medulloblastoma or Brain stem glioma
(Least to most severe)
Symptoms are rare and overlooked
Presentation based on tumor location
Parent guilt for lack of early treatment
26
Q

Brain Tumors Treatment

A

CT is the first step for diagnosis
Surgery and biposy – try to remove all if possible
Possible long term neuro defects not seen before surgery – infection, seizures, neuro defects, hydrocephalus, G/D issues, endocrine problems
Radiation to decrease the size of the tumor
Chemo does not cross the blood brain barrier well

27
Q

Pre- op Brain Tumors

A

GOOD NEURO ASSESSMENTS! Need to know the baseline

Teaching r/t loss of hair, large bandage on head, close monitoring, not all symptoms disappear after surgery

28
Q

Post- Op Brain Tumors

A

Monitor VS, temperature, neuro checks, pain, I/O’s, positioning
Look for increased ICP
Hypertonic fluid to decrease edema
Foley for urine output
Decrease stimulation, cooll compresses and opiods
Teach SE of radiation and chemo

29
Q

Neuroblastoma

A

Most common malignant EXTRA-CRANIAL solid tumor
Majority of the tumor develops in the adrenal gland or retro-peritoneal sympatheitc chain
“Silent tumors
Metastasis has occurred before the diagnosis

30
Q

Neuroblastoma Symptoms

A

Firm, non-tender, irregular mass in the abdomen that crosses the mid-line
Irritable, pallor, refusal to eat, weight loss
Urine frequency or retention

31
Q

Neuroblastoma Treatment

A 
DO NOT PALPATE THE ABDOMEN
Treatment depends on stage
Surgery to remove the tumor 
Radiation doe high stages 
Chemo is thee mainstay of therapy
Poor prognosis -- usually around stage 4
Parent guilt not recognizing symptoms
32
Q

Osteosarcoma

A

Malignant bone tumor
Distal femur or tibia near growth plate
Metastasis is high b/c of high vascular nature of bone
Lungs are the most common site

33
Q

Osteosarcoma Symptoms

A 
Hip and leg pain
Limping
Limited physical activity
Unable to hold heavy objects
Fever 
Respiratory distress
Palpable mass possible
34
Q

Osteosarcoma Treatment

A 
Rule out trauma and infection
Dx with bone biopsy
Chemo before surgery
Leg saving surgery or amputation 
**Body image, phantom pain, good stump care (permanent prosthesis 6-8 weeks post op), talk to teen with amputation
35
Q

Ewing’s Sarcoma

A

Malignant small, round cell tumor of the long bones
From marrow space of the bone
Whites>

36
Q

Ewing’s Sarcoma Symptoms

A

Leg/hip pain

Difficulty walking

37
Q

Ewing’s Sarcoma Treatment

A

Rule out trauma and infection
Diagnosis with bone biopsy – looks like an onion skin (outer layers are dry and flaky)
Chemo to reduce the tumor
High dose radiation to the site
Leg saving surgery is performed – amputation is rare
Education r/t to care of radiation site
Physical therapy to maximize function

38
Q

Nephroblastoma

A

Malignant renal and intra-abdominal tumor
Mass on ONE side of the abdomen
HTN
In one or both kidneys

39
Q

Nephroblastoma Treatment

A

Surgery is preformed to remove effected kidney and look for metastasis (occurs through the blood)
If in both kidneys – save the least effected one
Possible follow up chemo and radiation
DO NOT PALPATE THE ABDOMEN

40
Q

Nephroblastoma Pre-op

A

Monitor BP – HTN

Little time between diagnosis and surgery – coping

41
Q

Nephroblastoma Post- op

A 
Fluid management
Watch function of remaining kidney
Dialysis if both kidneys removed 
Look for UTI's, medication contradiction
AVOID CONTACT SPORTS
42
Q

Rhabdomyosarcoma

A

Highly malignant fast growing soft tissue sarcome
Primitive muscle cells
Grow out of control
Metastasis to lungs, bones, bone marrow and lymph nodes

43
Q

Rhabdomyosarcoma Symptoms

A

pg 1499

44
Q

Rhabdomyosarcoma Treatment

A 
Careful staging
Surgical removal of the primary tumor
Wide filed radiation and chemo next
Lower survival rate :/
**Anticipatory Grieving**
45
Q

Retinoblastoma

A

Congenital intraocular malignant tumor
Aries from retina, could be one or both eyes
Hereditary component
Monitor health eye!!

46
Q

Retinoblastoma Symptoms

A

Whitish glow of the pupil - cat’s eye reflex
Strabismus – cross eyed
Blindness is a late sign

47
Q

Retinoblastoma Treatment

A

Early stage needs unilateral irradiation and cryotheray
Attempt to preserve vision in affected eye
Bilateral disease – attempt to preserve least effected eye
Removal of the eye – place a glass eye

48
Q

Retinoblastoma Education

A

If eye removal teach about socket care and use a conformer to help keep the sock shape while waiting for the glass eye
Teach about cleaning the glass eye and what to do if it falls out
Later the child can do these tasks
Support the family! Guilt from genes, follow ups for those at risk for second tumors, eye care for whole family

NUR 440 Exam 3 (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions