Week 6 - Oncology

Question 1

Osteosarcoma

Answer 1

• Most common primary bone tumor
• Occurs in the growth plate in areas of high proliferation
• Femur is the most common space

Question 2

Osteosarcoma s/s

Answer 2

• constant pain that worsens with activity
• swelling
• tenderness with palpation

Question 3

Osteosarcoma diagnosis

Answer 3

X ray

Question 4

Leukemia

Answer 4

• Over production of lymphoblasts (immature WBC) leads to low hemoglobin, low platelet, and high WBC
• Most common childhood cancer
• ALL is the most common type
• Down syndrome kids are at higher risk

Question 5

Leukemia s/s

Answer 5

• frequent infection
• fever
• lmphadenopathy
• altered CBC
• bone pain
• unintentional weight loss

Question 6

Leukemia diagnosis

Answer 6

• bone marrow aspiration

- CBC

Question 7

Acute Non-Lymphocytic Leukemia (ALL)

Answer 7

• overproduction of WBC other than lymphocytes
• low survival rate
• need bone marrow transplant

Question 8

Acute Non-Lymphocytic Leukemia (ALL) s/s

Answer 8

• Frequent fever, infection
• Abnormal CBC
• Unintentional weight loss
• Paleness
• Fatigue
• Easy bruising

Question 9

Lymphomas

Answer 9

Bone cancer that starts in the lymph nodes

Question 10

Hodgkin’s Disease

Answer 10

• malignant neoplasm of lymph nodes
• mature B cells become malignant
• rare

Question 11

Hallmark sign of Hodgkin’s Disease

Answer 11

Reed Sternberg = large cell with multiple nuclei

Question 12

Hodgkin’s Disease s/s

Answer 12

• painless lump
• enlarged gland
• fevers
• weight loss
• night sweats

Question 13

Non-Hodgkin’s Lymphoma

Answer 13

• B or T cells become malignant
• worse than Hodgkin’s
• unknown cause
• tend to be older patients

Question 14

Non-Hodgkin’s Lymphoma s/s

Answer 14

• enlarged lymph nodes
• night sweats
• unintentional weight loss
• location dependent presentation
• cough, difficulty breathing
• abdominal pain, vomit
• urinary difficulties
• headaches

Question 15

Brain tumors

Answer 15

• mass in brain

- most common solid tumor in children

Question 16

Brain tumor s/s

Answer 16

Signs of ICP

• bulging fontanel
• ataxia (loss of body movement control)
• AM vomiting
• personality changes
• increased falls

Question 17

Neuroblastoma

Answer 17

• Overproduction of neuroblasts in early nerve cells
• starts in adrenal gland
• most common cancer in infancy

Question 18

Neuroblastoma s/s

Answer 18

• fevers
• unintentional weight loss
• location dependent
  Abdomen: swelling, constipation
  Chest: difficulty breathing
  Bone: pain and limping
  Facial: abnormal eye movement
  Spinal cord: weakness

Question 19

Retinoblastoma

Answer 19

• old solid tumor

- malignant glioma of the retina

Question 20

Retinoblastoma s/s

Answer 20

• leukocoria (white glow in pupil + NO red eye reflex)

- stabismus (crossed eyes)

Question 21

Oncologic Nursing Interventions

Answer 21

• draw blood
• give Abx and antifungals after CBC
• constipation and diarrhea interventions (s/e of chemo)
• sedation for radiation therapy
• surgical removal of tumor
• hemotopoietic stem cell transplant
• chemo
• monitor for transfusion reaction (back and chest pain, fever, chills, hypotension, rash, tachycardia, tachypnea)

Question 22

Oncologic teaching

Answer 22

• alopecia
• anemia
• extravasation (drug leakage during infusion)
• oral mucositis (avoid hot/acidic, soft tooth brushing, pain mgmt)
• neutropenia (wash hands, ED for fever)
• n/v (antiemetics, soft foods)
• thrombocytopenia