Exam 3 Oncology Flashcards Preview

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Flashcards in Exam 3 Oncology Deck (40):
1

Osteosarcoma =

= most common primary bone tumor

2

Osteosarcoma
1) Occurs where? why?
2) Area that is most common?
3) Cause =

1) Growth plate, bc of high proliferation
2) femur
3) some genetic predisposition (lethromany syndrome-devastating genetic mutation that will result in many cancers in their life)

3

S/S of Osteosarcoma (2)

- Sudden ____ may be a sign*
- X ray =

1) Pain that worsens with activity, constant but sharper w movement
2) Swelling, Tenderness with palpation

- fracture
- "sunburst appearance"

4

Leukemia =
(2)

= cancer of the blood
1) Acute Lymphoblastic Leukemia (ALL)
2) Acute Non-Lymphocytic (Myloid) Leukemia (AML)

5

Acute Lymphoblastic Leukemia =

Overgrowth of lymphoblasts ->

= overproduction of lymphoblasts (immature wbc's) in bone marrow

-> push out all other normal blood cells -> decreased rbc's, platelets, wbc (that are mature)

6

Causes of Leukemia
1) Leukemia is the ___ common form of childhood cancer
2) ALL is ___ common type of leukemia
3) Id____
4) Increased risk for children with?*

1) Most
2) Most
3) Idiopathic
4) Trisomy 21 (Down's syndrome)

7

S/S of Acute Lymphoblastic Leukemia (6)

- Fever
- Frequent Infection
- Lymphadenopathy
- Altered CBC -> low h/h, high wbc (but immature so not doing anything to prevent infection)
- Bone pain bc so much activity (lymphoblasts)
- Unintentional weight loss

8

Acute Nonlymphocytic Leukemia (AML) =

Etiology = __ most common form of childhood cancer, incidence increases w ____*

= overproduction of immature WBCs which interfere with production of normal cells

2nd, AGE*

9

Acute Nonlymphocytic Leukemia (AML)

- ____ presentation and tx to ALL, but ___ survival rate
- will mostly likely need?

- Similar, Lower
- bone marrow transplant

10

S/S of AML (5)

- Viral Picture
- Frequent fever, infection
- Abnormal CBC
- Unintenional weight loss
- Pale skin, Fatigue, (anemia) Easy Bruising (low platelets)

11

Lymphomas =
(2)

Lymphocytes =

Cancer that starts in the lymph nodes as opposed to other cancers which may move to lymph nodes

Hodgkins Lymphoma
Non Hodgkins Lymphoma

= type of wbc (leukocyte) responsible for immune responses - T cells, B cells

12

Hodgkins Disease =


Hallmark of Illness = *
-Starts w ____ then ->
- Usually in what age?

= Malignant neoplasm of lymph nodes, Mature B cells become malignant - abnormal cell growth

Reed Sternberg Cell (large cell with multiple nuclei)
- one lymph node, then spreads
- teens, young adults

13

S/S of Hodgkin's Disease (5)

- Painless lump
- Enlarged Gland
- Fever
- Weight loss
- Night Sweats*

14

Non- Hodgkin's Lymphoma =

= Group of malignant tumors of B or T lymphocytes

15

Etiology*

- Unknown, but thought to be some genetic risk
- EBV is associated with Burkitt's lymphoma (B cells)

16

S/S of Non-Hodgkin's Lymphoma (3)

Location Dependent (5)

- Enlarged Lymph Nodes
- Night Sweats
- Unintentional weight loss

1) Lung = cough, difficulty breathing
2) Abdominal pain
3) Vomiting
4) Urinary difficulties
5) Headache (CNS)

17

Nervous System Tumors (2)

Brain Tumors
Neuroblastoma

18

Brain Tumors =

- Most common ___ tumor
- ____ etiology

= benign or malignant mass found in the brain

- Solid
- Unknown

19

S/S of Brain Tumors =
(5)

= increased ICP
- Headache
- Vomiting
- Ataxia*
- Bulging fontanels
- Personality changes
- Increased falls

20

Neuroblastoma =

Often starts where?

= overproduction of neuroblasts in the bone marrow; neuroblasts = embryonic cell from which nerve fibers orginate

- In adrenal glands

21

S/S of Neuroblastoma (2)

Location Dependent
1) Abdomen (2)
2) Chest (1)
3) Bone (2)
4) Facial (1)
5) Spinal Cord (2)

- Fever
- Unintentional weight loss

1) usually starts here bc starts in adrenal gland: swelling, constipation
2) Difficulty breathing
3) Pain, limping
4) abnormal eye movements
5) weakness, movement issues

22

Old Solid Tumors (1)

Retinoblastoma

23

Retinoblastoma =

Cause is often ______
Screen in what age?

= Malignant Glioma of the Retina

Hereditary
Young children, infants

24

S/S of Retinoblastoma

1) Leukocoria
- white glow in pupil
- no red eye reflex
2) Strabismus
3) Abnormal eye deviation

25

General Oncologic Nursing Interventions (3)

1) Blood draws
2) Give Antibiotics, Antifungals
3) Teaching

26

Why do we draw blood?

To makes sure labs are at a certain threshold before giving chemo/other tx

27

Why do we give antibiotics/antifungals?
- Obtain what before administering?

Prophylactically bc chemo suppresses immune system
- blood culture

28

Teaching about
1) Alopecia =
2) A____ = teach s/s
3) C_____/D_____ dt chemo
4) Extravasation =
5 Oral m_____ =

1) Hair Loss
2) Anemia
3) Constipation/Diarrhea
4) Drug leakage of chemo into tissues
5) Mucositis = ulceration, inflammation of mucous membranes of GI tract

29

Education about Constipation (3)

- Lots of Fluids
- High Fiber foods
- Avoid bananas, cheese

30

Education about Diarrhea (3)

- Drink lots of fluids
- Eat bananas, potatoes (for potassium)
- Lay down after eating to slow digestion

31

Education about Mucositis (4)

- Soft tooth brush
- Mouthwash with lidocaine
- Pain meds
- Avoid hot, spicy foods

32

Education about Neutropenia (2)

Thrombocytopenia =

- Wash hands
- Go to ED for fever

= decreased platelets

33

Education about N/V
1) _____ at home
2) ____, __ to digest foods
3) ____ feedings out
4) Meds (3)

1) Antiemetics
2) Soft, easy
3) Spread
4) Ativan, benadryl, zofran

34

Oncologic Tx (6)

1) Hematopoietic stem cell transplantation
2) Radiation therapy
3) Surgery
4) Transfusion
5) Venous access devices
6) Chemo

35

Hematopoietic Stem Cell Transplantation =

- treats l____, l____ and others
- Bone marrow can be from (3)

= cells from bone marrow are given to help bone marrow function return

- lymphoma, leukemia
- patient, donor, stem cells from umbilical cord blood

36

Radiation Therapy =
- ___ sometimes necessary, why?
- most often used for ___ tumors, ___ tumors

= high energy x-rays to cancerous regions
- sedation, don't want pt to move bc need to target one area
- solid, brain

37

Chemotherapy
- Kills ____ and ____ cells
- Know ____ with other _-____
- Storage, schedule, monitoring

- cancer, and normal
- compatability w IV fluids

38

Surgery =
- Often used for __-____ masses
- can do __-____ to __ tumor before removal

Venous Access Devices =

= surgical removal of tumor
- non-cancerous
- neo-adjuvant, shrink

= Central lines inserted

39

Transfusion of blood/blood products
1) Types of blood products = (4)
2) Know institutional _____
3) Monitor closely for ____
- Signs of reaction (7)

1) whole blood, packed RBCs, Platelets, Plasma
2) policy
3) reaction
- Back/chest pain, hypotension, fever, chills, tachycardia, tachypnea, rash

40

Nursing Diagnoses for Hematologic + Oncologic Disorders

- Risk for knowledge deficit
- Ineffective peripheral tissue perfusion
- Imbalanced nutrition: less than body requirements
- At risk for infection
- Risk for impaired coping mechanism