CPHON CARE OF THE PEDIATRIC HEM/ONC
EXAM
Professional Practice - ANSWER Responsible for professional education and
growth
Cancer care constantly evolving, must keep abreast of new protocols, chemo
agents, symptom management, and safety issues developing
Joining professional organizations for career advancement
Scope and Standards of Practice - ANSWER Assessment, Diagnosis,
Outcomes, Planning, Implementation, Evaluation, Quality of Practice,
Education, Prof Practice Evaluation, Collegiality, Collaboration, Ethics,
Research, Resource Utilization, Leadership
Regulatory Standards and Guidelines - ANSWER Maintain current state
nursing licensure requirements
Deviate from scopes of nursing practice/requirement for CPHON recertification
Clinical Trials - ANSWER planned studies used to answer a medical question
protocols - written plans that serve as a detailed document to guide and manage
treatment
,Phase 1 CT - ANSWER identify MTD of drug/agent or combination of agents
starting dose in peds is generally 80% MTD in adults
treatment toxicities and pharmokinetics described from Phase 1 data
generally small trial 12-25 pts
Phase 2 CT - ANSWER find efficacy of the new agent/treatment in treating
certain types of cancer
disease specific, based on pharmacologic data
all pts must have measurable disease, normal organ function, reasonable life
expectancy and good performance status
usually best for pts that have not had intensive treatment
Phase 3 CT- ANSWER assess overall response, survival, and quality of life of
newly diagnosed pts using the new tx plan
compare whether tx is equal to or superior to the current standard tx
large # of pts
Phase 4 CT- ANSWER long-term safety and effectiveness of a tx
occur after new tx/drug is approved for standard use
usually less common in peds onc
decrease side effects, toxicities, and late effects while producing acceptable cure
rates
Research - ANSWER must adhere to federal guidelines
IRB
,parents/pts must sign informed consent that is IRB approved
children of appropriate age should provide assent
Elements of Informed Consent - ANSWER Dx and tx reccomendations in lay
terms
Alternative options (including not treating or participating in research)
benefit/burden of treatment options
purpose of research/any compensation
decision maker must be able to: - ANSWER receive information, weigh it out
in accordance with their medical situation and one's own values, communicate
the choice
Immunizations - ANSWER inactivated vaccines = safe (can be ineffective,
host is unable to develop cell mediated response)
NO MMR/varicella, live vaccines only in select circumstances
vaccines for family members/siblings - all family members, household contacts,
healthcare workers should be immunized
, Health Promotion - ANSWER ensure health teaching and health promotion-
ongoing education for optimal health and to prevent illess, establishing
relationship with pt and family, developing a trusting relationship, arranging
interpreter sevices when indicated, provide information as needed to not
overwhelm pt and caregiver, encourage pt and caregiver to ask questions
Transition of Care - ANSWER ensure once tx is complete family and/or pt can
verbalize importance of follow up visits (as indicated by disease and tx
received)
care coordination with pediatrician and nursing staff
education of school nurses and school staff - pt safety issues (physical
limitations, fever guidelines, med admin, any restrictions).
educate teachers and peers about disease/treatment
Chemotherapy- ANSWER prevent cancer cells from dividing, metastisizing,
and causing damage to body
prevents proliferation of cancer cells
cancer cells lose usual mechanisms for controlling growth
chemo forces apoptosis
multimodal- ANSWER chemo and radiation/surgery or all three
EXAM
Professional Practice - ANSWER Responsible for professional education and
growth
Cancer care constantly evolving, must keep abreast of new protocols, chemo
agents, symptom management, and safety issues developing
Joining professional organizations for career advancement
Scope and Standards of Practice - ANSWER Assessment, Diagnosis,
Outcomes, Planning, Implementation, Evaluation, Quality of Practice,
Education, Prof Practice Evaluation, Collegiality, Collaboration, Ethics,
Research, Resource Utilization, Leadership
Regulatory Standards and Guidelines - ANSWER Maintain current state
nursing licensure requirements
Deviate from scopes of nursing practice/requirement for CPHON recertification
Clinical Trials - ANSWER planned studies used to answer a medical question
protocols - written plans that serve as a detailed document to guide and manage
treatment
,Phase 1 CT - ANSWER identify MTD of drug/agent or combination of agents
starting dose in peds is generally 80% MTD in adults
treatment toxicities and pharmokinetics described from Phase 1 data
generally small trial 12-25 pts
Phase 2 CT - ANSWER find efficacy of the new agent/treatment in treating
certain types of cancer
disease specific, based on pharmacologic data
all pts must have measurable disease, normal organ function, reasonable life
expectancy and good performance status
usually best for pts that have not had intensive treatment
Phase 3 CT- ANSWER assess overall response, survival, and quality of life of
newly diagnosed pts using the new tx plan
compare whether tx is equal to or superior to the current standard tx
large # of pts
Phase 4 CT- ANSWER long-term safety and effectiveness of a tx
occur after new tx/drug is approved for standard use
usually less common in peds onc
decrease side effects, toxicities, and late effects while producing acceptable cure
rates
Research - ANSWER must adhere to federal guidelines
IRB
,parents/pts must sign informed consent that is IRB approved
children of appropriate age should provide assent
Elements of Informed Consent - ANSWER Dx and tx reccomendations in lay
terms
Alternative options (including not treating or participating in research)
benefit/burden of treatment options
purpose of research/any compensation
decision maker must be able to: - ANSWER receive information, weigh it out
in accordance with their medical situation and one's own values, communicate
the choice
Immunizations - ANSWER inactivated vaccines = safe (can be ineffective,
host is unable to develop cell mediated response)
NO MMR/varicella, live vaccines only in select circumstances
vaccines for family members/siblings - all family members, household contacts,
healthcare workers should be immunized
, Health Promotion - ANSWER ensure health teaching and health promotion-
ongoing education for optimal health and to prevent illess, establishing
relationship with pt and family, developing a trusting relationship, arranging
interpreter sevices when indicated, provide information as needed to not
overwhelm pt and caregiver, encourage pt and caregiver to ask questions
Transition of Care - ANSWER ensure once tx is complete family and/or pt can
verbalize importance of follow up visits (as indicated by disease and tx
received)
care coordination with pediatrician and nursing staff
education of school nurses and school staff - pt safety issues (physical
limitations, fever guidelines, med admin, any restrictions).
educate teachers and peers about disease/treatment
Chemotherapy- ANSWER prevent cancer cells from dividing, metastisizing,
and causing damage to body
prevents proliferation of cancer cells
cancer cells lose usual mechanisms for controlling growth
chemo forces apoptosis
multimodal- ANSWER chemo and radiation/surgery or all three
