NSG441 PEDS - FINAL EXAM QUESTIONS &
ANSWERS
The following are...?
· Unusual mass or swelling
· Unexplained paleness and loss of energy
· Sudden tendency to bruise
· Persistent, localized pain or limping
· Prolonged, explained fever or illness
· Frequent headaches, often with vomiting
· Sudden eye or vision changes
· Excessive, rapid weight loss
· Swollen lymph nodes, fever, abnormal CXR - Answer -general s+s of cancer
Most common type of cancer in children? - Answer -leukemia
What accounts for ½ of all pediatric cancers? - Answer -leukemia and lymphoma
Children w/ ________________ are more susceptible to certain cancers - Answer -
Trisomy 21 (Down syndrome)
(have a 20x higher risk of ALL than other children do)
If pts. have ulcers in their mouth or GI tract as chemo SE's, the nurse should... (3) -
Answer -- provide nutrition supplement (may be easier to drink something than eat solid
foods)
- give pain relief
- provide/ensure good oral care
The following are...
- encourage child to wear LOOSE fitting clothes over the area, to minimize any friction
or skin irritation
- wear long sleeve + long pants; stay in shade and wear sunscreen - Answer -
interventions for skin SE's of radiation
What are the 3 major problems Leukemia causes? - Answer -- Anemia due to
decreased RBCs
- Increased infections due to neutropenia
- Increased bleeding due to decreased platelets
- affects teens 15 - 19 years old
- primarily involves the lymph nodes
- lymph node biopsy is essential for dxing and staging of the cancer
,- s/s: enlarged lymph nodes, temp >100.4F for > 3 days, night sweats, unexplained wt.
Loss of >10% over last 6 mons, fatigue, anorexia, cough, abdominal discomfort, pruritus
- Answer -Hodgkin's Lymphoma
affects teens 15 - 19 years old - Answer -Hodgkin's lymphoma
primarily involves the lymph nodes - Answer -Hodgkin's lymphoma
- affects children 14 years and younger
( < 14 years old)
- disease is diffuse instead of nodular
- there is early + rapid dissemination
- s/s are more diverse
- invasion of meninges common (may see some CNS sumps) - Answer -Non-Hodgkins
lymphoma
- affects children 14 years and younger
( < 14 years old) - Answer -Non-Hodgkins lymphoma
- disease is diffuse instead of nodular - Answer -Non-Hodgkins lymphoma
- there is early + rapid dissemination - Answer -Non-Hodgkins lymphoma
- invasion of meninges common (may see some CNS sumps) - Answer -Non-Hodgkins
lymphoma
What is the main pre-op precaution for a child w/ a Wilms tumor? - Answer -no
abdominal palpation!
What type of sports precautions should a child w/ Wilms tumor be on? - Answer -
contact sports precautions - counsel child to participate in LOW contact sports (ex:
swimming)
After the initial dressing change from a retinoblastoma, what is used to keep the area
clean + free from the toddler's exploring fingers? - Answer -an eye patch
With retinoblastoma, what are 2 safety/injury prevention guidelines that are impt. to
maintain sight in unaffected eye? - Answer -- avoid contact sports
- use eye protection during all sports to protect the remaining eye
Which immune disorder mentioned in lecture can mimic symptoms of other GI
disorders? - Answer -eosinophilic GI disorder
- Overproduction of eosinophils causing chronic inflammation and tissue damage.
, - Variety of presenting s/s: reflux, vomiting, trouble swallowing, abdominal pain,
malabsorption, FTT (failure to thrive) - Answer -eosinophilic GI disorder - immune
disorder that can mimic other symptoms of GI disorders
Where are children cared for most often at the end of life? - Answer -at home or
brought to the hospital in their final days
The following describes...
provide symptomatic relief even if the intervention itself involves a risk of hastening
death - Answer -the principle of Double Effect
In the principle of Double Effect, the action must meet ___ conditions - Answer -4
conditions
The following are...?
1. An action that has one good (intended) and one bad (unintended but foreseeable)
effect is permissible if conditions are met:
2. The action itself must good or indifferent. Only the good consequences of the action
must be sincerely intended.
3. The good effect must not be produced by bad effect
4. There must be a compelling or proportionate reason for permitting the foreseeable
bad effect to occur. - Answer -the 4 conditions an action must meet to follow the
principle of Double Effect
The following are people who can...?
Legal guardians, health care power of attorney, health care surrogate - Answer -sign
Advanced Directives
To write a legally binding advanced directive, one needs to be... - Answer -18 or older
Parents can write advanced directives for their children.
T/F? - Answer -True!
Little to no understanding of death; Reactions manifest by life-style changes in child's
routine
Ex: they just see that their caregiver is no longer there - Answer -infants/toddlers
understanding of death
- Have some understanding but may *conceive of death as prolonged sleep*
-Do not understand the concept of finality (and inevitability) of death.
- May be afraid they caused something to happen that caused someone to die or that
they are being punished b/c that person went away - Answer -preschool children
understanding of death
ANSWERS
The following are...?
· Unusual mass or swelling
· Unexplained paleness and loss of energy
· Sudden tendency to bruise
· Persistent, localized pain or limping
· Prolonged, explained fever or illness
· Frequent headaches, often with vomiting
· Sudden eye or vision changes
· Excessive, rapid weight loss
· Swollen lymph nodes, fever, abnormal CXR - Answer -general s+s of cancer
Most common type of cancer in children? - Answer -leukemia
What accounts for ½ of all pediatric cancers? - Answer -leukemia and lymphoma
Children w/ ________________ are more susceptible to certain cancers - Answer -
Trisomy 21 (Down syndrome)
(have a 20x higher risk of ALL than other children do)
If pts. have ulcers in their mouth or GI tract as chemo SE's, the nurse should... (3) -
Answer -- provide nutrition supplement (may be easier to drink something than eat solid
foods)
- give pain relief
- provide/ensure good oral care
The following are...
- encourage child to wear LOOSE fitting clothes over the area, to minimize any friction
or skin irritation
- wear long sleeve + long pants; stay in shade and wear sunscreen - Answer -
interventions for skin SE's of radiation
What are the 3 major problems Leukemia causes? - Answer -- Anemia due to
decreased RBCs
- Increased infections due to neutropenia
- Increased bleeding due to decreased platelets
- affects teens 15 - 19 years old
- primarily involves the lymph nodes
- lymph node biopsy is essential for dxing and staging of the cancer
,- s/s: enlarged lymph nodes, temp >100.4F for > 3 days, night sweats, unexplained wt.
Loss of >10% over last 6 mons, fatigue, anorexia, cough, abdominal discomfort, pruritus
- Answer -Hodgkin's Lymphoma
affects teens 15 - 19 years old - Answer -Hodgkin's lymphoma
primarily involves the lymph nodes - Answer -Hodgkin's lymphoma
- affects children 14 years and younger
( < 14 years old)
- disease is diffuse instead of nodular
- there is early + rapid dissemination
- s/s are more diverse
- invasion of meninges common (may see some CNS sumps) - Answer -Non-Hodgkins
lymphoma
- affects children 14 years and younger
( < 14 years old) - Answer -Non-Hodgkins lymphoma
- disease is diffuse instead of nodular - Answer -Non-Hodgkins lymphoma
- there is early + rapid dissemination - Answer -Non-Hodgkins lymphoma
- invasion of meninges common (may see some CNS sumps) - Answer -Non-Hodgkins
lymphoma
What is the main pre-op precaution for a child w/ a Wilms tumor? - Answer -no
abdominal palpation!
What type of sports precautions should a child w/ Wilms tumor be on? - Answer -
contact sports precautions - counsel child to participate in LOW contact sports (ex:
swimming)
After the initial dressing change from a retinoblastoma, what is used to keep the area
clean + free from the toddler's exploring fingers? - Answer -an eye patch
With retinoblastoma, what are 2 safety/injury prevention guidelines that are impt. to
maintain sight in unaffected eye? - Answer -- avoid contact sports
- use eye protection during all sports to protect the remaining eye
Which immune disorder mentioned in lecture can mimic symptoms of other GI
disorders? - Answer -eosinophilic GI disorder
- Overproduction of eosinophils causing chronic inflammation and tissue damage.
, - Variety of presenting s/s: reflux, vomiting, trouble swallowing, abdominal pain,
malabsorption, FTT (failure to thrive) - Answer -eosinophilic GI disorder - immune
disorder that can mimic other symptoms of GI disorders
Where are children cared for most often at the end of life? - Answer -at home or
brought to the hospital in their final days
The following describes...
provide symptomatic relief even if the intervention itself involves a risk of hastening
death - Answer -the principle of Double Effect
In the principle of Double Effect, the action must meet ___ conditions - Answer -4
conditions
The following are...?
1. An action that has one good (intended) and one bad (unintended but foreseeable)
effect is permissible if conditions are met:
2. The action itself must good or indifferent. Only the good consequences of the action
must be sincerely intended.
3. The good effect must not be produced by bad effect
4. There must be a compelling or proportionate reason for permitting the foreseeable
bad effect to occur. - Answer -the 4 conditions an action must meet to follow the
principle of Double Effect
The following are people who can...?
Legal guardians, health care power of attorney, health care surrogate - Answer -sign
Advanced Directives
To write a legally binding advanced directive, one needs to be... - Answer -18 or older
Parents can write advanced directives for their children.
T/F? - Answer -True!
Little to no understanding of death; Reactions manifest by life-style changes in child's
routine
Ex: they just see that their caregiver is no longer there - Answer -infants/toddlers
understanding of death
- Have some understanding but may *conceive of death as prolonged sleep*
-Do not understand the concept of finality (and inevitability) of death.
- May be afraid they caused something to happen that caused someone to die or that
they are being punished b/c that person went away - Answer -preschool children
understanding of death
