Card Set Information
Cancer final exam for N173
Who has a high likelihood of getting Leukemia?
What lab will dx leukemia?
High amounts of immature WBC-Blasts
But bone marrow dysfunction showing decreased WBC, RBC, platelets
S/S that you have leukemia....
DX of Leukemia
Bone Marrow Aspiration
S/S of Lymphomas
painless enlarged lymph node, tonsils and adenoids
How do you treat Leukemia?
If relapse..redo chemo then move to bone marrow transplant and stem cell transplant
How do treat Lymphomas?
Bone Marrow Transplant
Stem Cell Transplant
What cancer is at risk for tumor lysis?
Two types of bone tumors
Osteosarcoma and Ewings Sarcoma
Osteosarcoma is usually found where? and is mistaken for what?
femur, tibia, humurus
growing pains....may limp
Ewing's sarcoma is usually found where? and is mistaken for what?
femur, vertebra, pelvis, ribs
infection-pain, fever and a soft tissue mass around affected bone
Which bone cancer is most likely to result in amputation
How is Osteosarcoma treated?
Chemo before and after surgery
Radiation only for pain control/palliative care
How is Ewing's Sarcoma treated
Chemotherapy before surgery to debulk the tumor and then resect the tumor
What is Nueroblastoma?
it is a solid tumor that is typically found in the abdomen and on adrenal glands
What can Neuroblastoma be mistaken for?
cold or flu
S/S of Neuroblastoma
Myoclonic/Rotational eye movements
*Mass across midline of abdomen
2 cancers you don't want to palpate
Neuroblastoma and Wilm's Tumor (Nephroblastoma)
How do you treat Neuroblastoma?
Chemo and Radiation and Bone Marrow Transplant
Name a Neprhroblastoma cancer
What is Wilm's Tumor?
S/S of Wilm's tumor
firm abdominal mass on one side
How do you treat Wilm's Tumor?
Chemo and Radiation
What do you monitor closely on a patient with Wilm's Tumor?
Blood pressure....increases prior to surgery and can go either way after surgery
S/S of brain tumor
Vomiting in AM
change in LOC
Increased head circumfrence
Change in balance
Change in mood
Treatment for brain tumors
Post op for a child after brain surgery
watch for seizures, vomiting, facial edema
Complications of brain tumors/surgery
1,500-2,000 low risk for infection
500-1,000 Moderate risk for infection
<500 severe risk for infection
Bleeding precautions when a kid has thrombocytopenia
no rectal temps
avoid trauma, punctures and invasive procedures when possible
What is given prophylactically with chemo?
antibiotics to prevent infection
How do you calculate ANC?
WBC x Segs x Bands
What does chemo wipe out?
immune system-bone marrow
treatment of areas not caught during induction
longest phase with a goal of maintaining remission and preventing relapse
Allogenic-donated by family member or stranger
What sort of vaccines don't you give to a person on chemo?
Only sign of infection
fever....no immune response so wont see normal signs of infection
If patient has a fever what will I do?
antibiotics for T>38
cultures-blood, urine and sputum
What childhood illness can be deadly for a chemo patient
Antibiotic that prevents opportunistic infections
Central Line Care
Need to teach patient impeccable care
cap and tubing changes
s/s of infection
culture blood from line and site
Early Septic Shock s/s/
Late Septic Shock s/s
lethargy to coma
widened pulse pressure
increased cap. refill time
Problem with reverse isolation
cant go to play room or outside of room....get child life to help with diversional needs
How do we care for stomatitis
routinely check mouth for signs of infection
mouthwash for cleaning and pain relief
oral Nystatin for candida
What's tumor lysis?
when the cancer cells are killed they dump their intracellular contents in to the extracellular fluids
What are the lytes dumped in to extra cellular fluids with tumor lysis? Weird one?
Complication from K and P being dumped during tumor lysis?
can cause acute renal failure
Who gets tumor lysis a lot?
leukemias and non hodgkins lymphoma
How do you treat tumor lysis syndrome?
2 meds given to a person experiencing tumor lysis syndrome to decrease urine acidity