Ricci Chapters 50&51 || with Complete Solutions.
How does childhood cancer differ from adult cancer? correct answers Most common sites for
childhood cancer are: blood, bone, lymph, brain, kidney and muscle. As compared to adults:
breast, lung, prostate, bowel, and bladder. Environmental factors influence the cause of adult
cancers whereas, there is a minimal effect on childhood cancers. Childhood cancers are more
responsive to treatment if caught early whereas adult cancers do not respond as well.
(Comparison chart 50.1 p. 1814)
A malignancy that occurs in the kidneys or abdomen is known as? correct answers ~ Wilms'
Tumor (nephroblastoma)
~ Metastases are rare in this type of tumor
~ Usually occurs unilaterally
Neuroblastoma correct answers ~ A malignancy that occurs in the adrenal gland, sympathetic
chain of the peritoneal area, head, neck, pelvis or chest.
~ More common in males than females
~ Half of all cases have metastasized before diagnosis.
Assessment of Wilms' tumor correct answers ~ painless/ nontender, firm mass or abdominal
swelling
~ fatigue and weight loss
~ hematuria
~ HTN
~ Metastasis= dyspnea, cough, SOB and chest pain.
Assessment of Neuroblastoma correct answers ~ Few findings
~ periorbital ecchymosis, proptosis (exophthalmos), bone pain and irritability.
Nursing Care for Wilms' Tumor correct answers ~ Do NOT palpate the abdomen
~ Prevent trauma to the tumor site (be careful handling the pt)
~ Monitor for delays in growth and development
~ Monitor for signs of infection
~ Keep lips and mucous membranes hydrated
~ Do not provide false reassurance
Treatment of tumors correct answers ~ Surgery, chemotherapy and radiation
~ Central Venous Access devices may be used for long term chemo administration.
Leukemia correct answers ~ Most common cancer of childhood
~ Most common in caucasian males
~ Pts with Down Syndrome are at higher risk
~ Affects both bone marrow and the lymphatic system
~ Two types: acute lymphoid leukemia and nonlymphoid leukemia
~ Leukemia causes an increase production of immature WBC that infiltrate the bone marrow
causing crowding.
, ~ Due to the cramped area RBC, Mature WBC and platelets are not able to properly form.
Early manifestations of leukemia correct answers low-grade fever
pallor
bruising and petechiae
listlessness
enlarge sliver, lymph nodes and joints
HA
N/V
Unsteady gait
Late manifestations of leukemia correct answers Pain
hematuria
mouth ulcerations
enlarged kidneys and testicles
manifestations of Increased ICP
A CBC for Leukemia will show correct answers ↓RBC (anemia)
↓ platelets (thrombocytopenia)
↓ WBC (neutropenia)
↑ leukemic blasts (immature WBC)
What is the most definitive diagnostic procedure for leukemia? correct answers ~ Bone marrow
aspiration/ biopsy analysis
~ Test will show ↑ in blasts
4 phases of Chemo for Leukemia correct answers 1) induction: achieves complete remission or
<5% of leukemic cells in the bone marrow.
2) CNS prophylaxis: prevent invasion of the CNS
3) Intensification: Destroyed any remaining cancer cells followed by delayed intensification to
prevent any resistance cancer cells from emerging
4) Maintenance: Sustains the remission phase
Hematopoietic stem cell transplant (HCST)
Treatment for leukemia remissions correct answers ~ Indicated for clients with a first remission
of AML (nonlymphoid) or a second remission of ALL (acute lymphoid)
stem cells are donated by another person
~ Donor stem cells are administered via IV infusion
~ Protective isolation needs to be implemented
-private, positive pressure room with HEPA air filtration and at least 12 air echanges/ hr.
Respirator mask, gown and gloves needed to enter the room. No dried/fresh or potted plants or
flowers.
~ Child is at an increase for infection until stem cells grow.
Hodgkin's Disease correct answers ~ Is a type of lymphoma
~ A malignancy of a single node or along a lymph node chain
How does childhood cancer differ from adult cancer? correct answers Most common sites for
childhood cancer are: blood, bone, lymph, brain, kidney and muscle. As compared to adults:
breast, lung, prostate, bowel, and bladder. Environmental factors influence the cause of adult
cancers whereas, there is a minimal effect on childhood cancers. Childhood cancers are more
responsive to treatment if caught early whereas adult cancers do not respond as well.
(Comparison chart 50.1 p. 1814)
A malignancy that occurs in the kidneys or abdomen is known as? correct answers ~ Wilms'
Tumor (nephroblastoma)
~ Metastases are rare in this type of tumor
~ Usually occurs unilaterally
Neuroblastoma correct answers ~ A malignancy that occurs in the adrenal gland, sympathetic
chain of the peritoneal area, head, neck, pelvis or chest.
~ More common in males than females
~ Half of all cases have metastasized before diagnosis.
Assessment of Wilms' tumor correct answers ~ painless/ nontender, firm mass or abdominal
swelling
~ fatigue and weight loss
~ hematuria
~ HTN
~ Metastasis= dyspnea, cough, SOB and chest pain.
Assessment of Neuroblastoma correct answers ~ Few findings
~ periorbital ecchymosis, proptosis (exophthalmos), bone pain and irritability.
Nursing Care for Wilms' Tumor correct answers ~ Do NOT palpate the abdomen
~ Prevent trauma to the tumor site (be careful handling the pt)
~ Monitor for delays in growth and development
~ Monitor for signs of infection
~ Keep lips and mucous membranes hydrated
~ Do not provide false reassurance
Treatment of tumors correct answers ~ Surgery, chemotherapy and radiation
~ Central Venous Access devices may be used for long term chemo administration.
Leukemia correct answers ~ Most common cancer of childhood
~ Most common in caucasian males
~ Pts with Down Syndrome are at higher risk
~ Affects both bone marrow and the lymphatic system
~ Two types: acute lymphoid leukemia and nonlymphoid leukemia
~ Leukemia causes an increase production of immature WBC that infiltrate the bone marrow
causing crowding.
, ~ Due to the cramped area RBC, Mature WBC and platelets are not able to properly form.
Early manifestations of leukemia correct answers low-grade fever
pallor
bruising and petechiae
listlessness
enlarge sliver, lymph nodes and joints
HA
N/V
Unsteady gait
Late manifestations of leukemia correct answers Pain
hematuria
mouth ulcerations
enlarged kidneys and testicles
manifestations of Increased ICP
A CBC for Leukemia will show correct answers ↓RBC (anemia)
↓ platelets (thrombocytopenia)
↓ WBC (neutropenia)
↑ leukemic blasts (immature WBC)
What is the most definitive diagnostic procedure for leukemia? correct answers ~ Bone marrow
aspiration/ biopsy analysis
~ Test will show ↑ in blasts
4 phases of Chemo for Leukemia correct answers 1) induction: achieves complete remission or
<5% of leukemic cells in the bone marrow.
2) CNS prophylaxis: prevent invasion of the CNS
3) Intensification: Destroyed any remaining cancer cells followed by delayed intensification to
prevent any resistance cancer cells from emerging
4) Maintenance: Sustains the remission phase
Hematopoietic stem cell transplant (HCST)
Treatment for leukemia remissions correct answers ~ Indicated for clients with a first remission
of AML (nonlymphoid) or a second remission of ALL (acute lymphoid)
stem cells are donated by another person
~ Donor stem cells are administered via IV infusion
~ Protective isolation needs to be implemented
-private, positive pressure room with HEPA air filtration and at least 12 air echanges/ hr.
Respirator mask, gown and gloves needed to enter the room. No dried/fresh or potted plants or
flowers.
~ Child is at an increase for infection until stem cells grow.
Hodgkin's Disease correct answers ~ Is a type of lymphoma
~ A malignancy of a single node or along a lymph node chain
