Cancer Final

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Cancer Final
2014-03-07 13:50:12

Cancer final exam for N173
Show Answers:

  1. Who has a high likelihood of getting Leukemia?
    Downs kids
  2. What lab will dx leukemia?
    High amounts of immature WBC-Blasts

    But bone marrow dysfunction showing decreased WBC, RBC, platelets
  3. S/S that you have leukemia....
    • Bruising
    • Petachiae
    • Nose bleeds
    • Wt. loss
    • Weak
    • Chills/Fever
    • Bone pain
    • Tachy
    • UTI/URI
  4. DX of Leukemia
    • CBC
    • Bone Marrow Aspiration
    • Lumbar Puncture
  5. S/S of Lymphomas
    painless enlarged lymph node, tonsils and adenoids
  6. How do you treat Leukemia?
    • chemotherapy
    • If relapse..redo chemo then move to bone marrow transplant and stem cell transplant
  7. How do treat Lymphomas?
    • Chemo
    • Bone Marrow Transplant
    • Stem Cell Transplant
  8. What cancer is at risk for tumor lysis?
  9. Two types of bone tumors
    Osteosarcoma and Ewings Sarcoma
  10. Osteosarcoma is usually found where?  and is mistaken for what?
    femur, tibia, humurus

    growing pains....may limp
  11. 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
  12. Which bone cancer is most likely to result in amputation
  13. How is Osteosarcoma treated?
    Chemo before and after surgery

    Possible amputation

    Radiation only for pain control/palliative care
  14. How is Ewing's Sarcoma treated
    Chemotherapy before surgery to debulk the tumor and then resect the tumor
  15. What is Nueroblastoma?
    it is a solid tumor that is typically found in the abdomen and on adrenal glands
  16. What can Neuroblastoma be mistaken for?
    cold or flu
  17. S/S of Neuroblastoma
    • Anemia
    • Fever
    • Myoclonic/Rotational eye movements
    • *Mass across midline of abdomen
    • Anorexia/diarrhea/constipation
    • Respiratory distress
    • Swallowing Difficulty
    • Abnormal Gait
  18. 2 cancers you don't want to palpate
    Neuroblastoma and Wilm's Tumor (Nephroblastoma)
  19. How do you treat Neuroblastoma?
    • Surgery
    • Chemo and Radiation and Bone Marrow Transplant
  20. Name a Neprhroblastoma cancer
    Wilm's Tumor
  21. What is Wilm's Tumor?
    renal tumor
  22. S/S of Wilm's tumor
    • firm abdominal mass on one side
    • abdominal pain
    • HTN
    • Hematuria
    • Anemia/Fatigue
    • Fever
  23. How do you treat Wilm's Tumor?
    • Nephrectomy
    • Chemo and Radiation
  24. 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
  25. S/S of brain tumor
    • Headache
    • Vomiting in AM
    • change in LOC
    • Increased head circumfrence
    • Change in balance
    • Change in mood
    • Vision changes
  26. Treatment for brain tumors
    • surgeries
    • radiation
    • chemo
    • supportive care
  27. Post op for a child after brain surgery
    • raise HOB
    • monitor ICP
    • prevent infection
    • protect airway
    • watch for seizures, vomiting, facial edema
  28. Complications of brain tumors/surgery
    • neuro deficits
    • learning disabilities
    • developmental delays
    • paralysis
    • Bell's Palsy
    • Seizures
    • Blindness
    • Respiratory/airway compromise
    • Hydrocephalus
    • coma
  29. Normal HGB
  30. Normal Platelets
  31. Normal WBC
  32. Normal ANC
  33. ANC levels
    • 1,500-2,000 low risk for infection
    • 500-1,000 Moderate risk for infection
    • <500 severe risk for infection
  34. Bleeding precautions when a kid has thrombocytopenia
    • soft toothbrush
    • no rectal temps
    • avoid trauma, punctures and invasive procedures when possible
  35. What is given prophylactically with chemo?
    antibiotics to prevent infection
  36. How do you calculate ANC?
    WBC x Segs x Bands
  37. What does chemo wipe out?
    immune system-bone marrow
  38. Intensification
    treatment of areas not caught during induction
  39. Maintenance
    longest phase with a goal of maintaining remission and preventing relapse
  40. Bone marrow-
    • Autologous-own marrow
    • Allogenic-donated by family member or stranger
  41. What sort of vaccines don't you give to a person on chemo?
    live virus
  42. Only sign of infection immune response so wont see normal signs of infection
  43. If patient has a fever what will I do?
    • antibiotics for T>38
    • cultures-blood, urine and sputum
  44. What childhood illness can be deadly for a chemo patient
    chicken pox
  45. Antibiotic that prevents opportunistic infections
  46. Central Line Care
    • Need to teach patient impeccable care
    • routine flushes
    • dressing changes
    • cap and tubing changes
    • s/s of infection
    • culture blood from line and site
  47. Early Septic Shock s/s/
    • bounding pulses
    • warm extremities
    • flushing
    • tachypnea
    • tachycardia
    • irritability
    • restless
  48. Late Septic Shock s/s
    • lethargy to coma
    • hypotension
    • widened pulse pressure
    • tachycardia-bradycardia episodes
    • weak pulses
    • cold extremities
    • increased cap. refill time
    • peripheral cyanosis
  49. Problem with reverse isolation
    cant go to play room or outside of room....get child life to help with diversional needs
  50. How do we care for stomatitis
    • routinely check mouth for signs of infection
    • mouthwash for cleaning and pain relief
    • oral Nystatin for candida
  51. What's tumor lysis?
    when the cancer cells are killed they dump their intracellular contents in to the extracellular fluids
  52. What are the lytes dumped in to extra cellular fluids with tumor lysis?  Weird one?
    • Hyperkalemia
    • Hyperphosphatemia
    • Hypocalcemia
  53. Complication from K and P being dumped during tumor lysis?
    can cause acute renal failure
  54. Who gets tumor lysis a lot?
    leukemias and non hodgkins lymphoma
  55. How do you treat tumor lysis syndrome?
    • treat hyperkalemia
    • intensive hydration
  56. 2 meds given to a person experiencing tumor lysis syndrome to decrease urine acidity
    • Bicarbonate
    • Allopurinol