N301: OB/Peds

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Author:
Martia
ID:
253531
Filename:
N301: OB/Peds
Updated:
2013-12-16 22:36:46
Tags:
Child Cancer Life Threatening Condition FINAL
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Description:
nursing school
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  1. diagnostic tests for cancer
    • used to ID source of cancer, determine if metastasized, and stage of cancer
    • blood work - CBC, electrolytes, liver function tests, absolute neutrophil count (# of neutrophils actually doing work)
    • bone marrow aspiration/biopsy
    • lumbar puncture - to look for abnormal cancers in spinal fluid
    • tumor biopsy - may also be used to remove or debulk a tumor
  2. tx of cancer - surgery
    • remove/debulk tumor
    • determine stage and type
  3. tx of cancer - chemo
    • kills good and bad cells
    • timed with cell cycle for max destruction
    • different drugs work on different phases of cell growth
  4. tx of cancer - radiation
    • energy destroys DNA and cell
    • may be curative or palliative
    • used for local and regional control of cancer
  5. tx of cancer - biotherapy
    • use parts of the body already programmed to destroy cells to target cancer cells
    • tumor necrosis factor
    • HPV vaccine to help fight ovarian cancer
  6. tx of cancer - bone marrow/stem cell transplant
    • kill cancer with chemo or radiation then resupply body with stem cells
    • uses own bone marrow, donor marrow, umbilical cord blood
  7. clinical manifestations of cancer
    • pain -  direct or indirect
    • cachexia
    • anemia
    • bruising
    • neuro symptoms - increased ICP, eye abnormalities
    • palpable mass
  8. metabolic emergency - tumor lysis syndrome
    • lysis of tumor cells
    • results in release of uric acid, potassium, phosphate, calcium(decreased levels)
    • serum sodium levels may decrease
    • most common in Burkitt's lymphoma and acute lymphocytic leukemia
    • tx - vigorous hydration, monitor I&Os for oliguria, monitor for altered LOC, give allopurinol to breakdown uric acid
  9. metabolic emergency - septic shock
    • risk factor - immunosuppression
    • tx - cultures then abx
  10. metabolic emergency - hypercalcemia
    occurs when bone is destroyed and releases calcium
  11. hematologic emergency - bone marrow suppression
    • results in anemia and thrombocytopenia then hemorrhage occurs (GI bleeding, stroke, DIC)
    • tx - platelets and packed RBCs
  12. hematologic emergency - hyperleukocytosis
    • high # of leukemic blast cells
    • infiltrate and obstruction in small blood vessels
    • tx - allopurinol, hydration, bicarbonate infusion
  13. space occupying lesions
    • rapid tumor growth may cause spinal cord compression, increased ICP, brain herniation, seizures, heptamegaly, vena cava syndrome
    • tx - decrease size, radiation, chemo, corticosteroids
  14. clinical manifestations brain tumors
    • HA
    • N/V
    • irritable and dizzy
    • trunca ataxia - can't walk straight
    • change in vision or hearing
    • fatigue
  15. brain tumor tx
    • depends on type
    • radiation - not used for kids under 3
    • chemo - intrathecally d/t blood brain barrier
    • pain meds
  16. neuroblastoma
    • smooth, hard, nontender mass
    • occurs anywhere along sympathetic nervous system chain
    • abd, thoracic area, adrenal area, cervical area
  17. clinical manifestations of neuroblastoma
    • retroperitoneal mass - altered bowel or bladder function, weight loss, abd distention, enlarged liver
    • mediastinal mass - dyspnea, infection
  18. tx of neuroblastoma
    • surgical removal of mass
    • then chemo - multiple drugs used
    • radiation often used when not responsive to chemo

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