The Child With Malignancy (Ch 22)

Front 1

The nurse caring for the pediatric client with diffuse large B-cell lymphoma knows that 2/3 of the cases present with advanced disease, most commonly located where?

Back 1

abdomen

Front 2

The nurse caring for a cancer patient recognizes signs and symptoms of syndrome of inappropriate anti-diuretic hormone (SIADH) in a patient. What are the recommended interventions for this emergency situation? (4)

Back 2

1. monitor intake and output
2. restrict fluids to below maintenance levels
3. monitor specific gravity of each voiding
4. monitor serum sodium levels

Front 3

A cancer patient is diagnosed with typhitis. What are the recommended interventions? (3)

Back 3

1. administer broad-spectrum antibiotics IV
2. provide supportive care to manage symptoms
3. anticipate surgical intervention to remove infarct/inflammation if necessary

Front 4

The nurse is assisting with a bone marrow aspiration and biopsy for a 6-year old. What do you tell the child and family to prepare them for the test? (3)

Back 4

1. The procedure is done using aseptic technique.
2. Patient is positioned based on the site with a pillow or folded blanket under the abdomen to elevate the hips
3. Parents will be allowed to stay in the room for emotional support.

Front 5

The nurse caring for a patient with leukemia documents the following signs that are clinical features of the disease (select all that apply):
A. lymphadenopathy
B. anorexia
C. increased hemoglobin
D. increased platelet count
E. bruising
F. sore throat

Back 5

A. lymphadenopathy
B. anorexia
E. bruising
F. sore throat

Front 6

The oncology nurse is alert for signs and symptoms of disseminated intravascular coagulation (DIC). Which of the following is a sign of this emergency condition?
A. decreased D-dimer assay
B. increased anti-thrombin III levels
C. platelet count 10,000
D. uncontrolled bleeding

Back 6

D. uncontrolled bleeding

Also, increased D-dimer, prolonged PT and PTT, platelet count 20,000

Front 7

Parents of a child with cerebral astrocytoma ask what their child's prognosis is. What is an accurate response?

Back 7

Prognosis is favorable with complete resection, and

patients have minimal neurological defects postoperatively

Front 8

A nurse is assessing for signs of a malignancy. Which of the following indicates a soft tissue mass? (all that apply)
A. drainage from ear
B. swelling around eyes
C. cranium masses
D. pallor
E. bruising and petechiae
F. night sweats

Back 8

A. drainage from ear
B. swelling around eyes
C. cranium masses

also: asymetry of face, jaw pain or swelling
pallor, bruising, petechiae - leukemia
night sweats - hodgkin's

Front 9

The pediatric nurse examines radiographs of a patient that shows lesions on the bone. This is indicative of:
A. neuroblastoma
B. Hodgkin lymphoma
C. Non-Hodgkin lymphoma
D. Ewing sarcoma

Back 9

D. Ewing sarcoma

PET scan is most effective for diagnosing Hodgkin, non Hodgkin or neuroblastoma

Front 10

What diagnostic test differentiates neuroblastoma from other tumors?

Back 10

urine catecholamines (VMA, HVA)

Front 11

Characteristics of a group III retinoblastoma (2)

Back 11

solitary tumors larger than 10 disk diameters behind the equator

any lesion anterior to the equator

Front 12

2nd leading cause of death of kids (after accidents)

Back 12

cancer

Front 13

Therapy accomplished by providing various combinations of therapies, such as chemo, radiation, surgery, HSCT, BRMs

Back 13

multimodal

Front 14

Most common tumor that precedes both hematologic and nonhematologic secondary tumors

Back 14

Hodgkin's disease

Front 15

considered a cancer survivor when disease-free for ___ following ___ phase of ____

Back 15

5 years following the maintenance phase of chemotherapy

Front 16

Therapy that's cytotoxic, damages synthesis of nucleic acids, breaks DNA or RNA molecule, or causes double stranded breaks in the molecules

Back 16

radiation

Front 17

induction

Back 17

initial phase of chemotherapy

Front 18

relapse

Back 18

cancer returns

Front 19

remission

Back 19

temporary or permanent response to therapy that causes decrease or absence of the primary malignancy

Front 20

observation phase

Back 20

phase of chemotherapy when treatment is finished

Front 21

maintenance phase

Back 21

designated period during which treatment is continued to destroy any residual cancer cells

Front 22

The nurse assisting with stem cell transplantation knows that 2 kinds of transplants are performed. ___ which uses the child's own stem cells and ___ which uses a matched donor's cells

Back 22

autologous

allogeneic

Front 23

suppression of bone marrow function

Back 23

myelosuppression

Front 24

Period when immune cell count is lowest (7-10 days after receiving chemotherapy)

Back 24

nadir

Front 25

Systemic disease outside the blood and bone marrow

Back 25

extramedullary

Front 26

Place the following stages of chemotherapy in the order in which they are initiated in the process:

maintenance
induction
remission
observation
consolidation

Back 26

1. induction
2. remission
3. consolidation
4. maintenance
5. observation

Front 27

Describe how cancers in children differ from cancers in adults

Back 27

Child: most cancers arise from mesodermal layer -- 92% and 8% from neuroectodermal layer (CNS tumors)

Adults: involve epithelial tissue and are called carcinomas. Epithelial cancer is quite rare in kids under 15

Front 28

What are nursing responsibilities for the child receiving radiation treatments? (3)

Back 28

1. Provide concrete information to the child and the family about the procedure and its side effects

2. Prepare the child for the treatment.

3. Manage the side effects and prevent further complications

Front 29

What are the mechanisms of action of biologic response modifiers (BRMs)? (3)

Back 29

1. modify the immune response to cancer

2. act directly against the tumor by killing it or suppressing its growth

3. alter other biological factors that can influence viability of the tumor