NUR 254 EXAM 4 SCRIPT COMPLETE
ANSWERS GRADED A+
◉ Ewing Sarcoma: Treatment & Interventions
Answer: o Radiation
o Chemo
o Possible limb salvage/amputation
◉ Wilms tumor (nephroblastoma): Etiology/Diagnositcs
Answer: Tumor in the kidney. DON'T PALPATE** Will rupture and
SPREAD CANCER**
BEST prognosis in childhood cancers, 2-3 years of age
o CT, MRI, U/S of abdomen
◉ Wilms tumor (nephroblastoma): S/S
Answer: o Painless firm mass in abdomen deep in the flank area,
conned to one side**
o Hematuria
o Confined to one side
o Weight loss, anorexia
o Fever
o HTN (maybe)
,o Anemia
o Lymphadenopathy: swollen lymph nodes
o Painless swelling
o Pallor
◉ Wilms tumor (nephroblastoma): Treatment & Interventions
Answer: o Surgery combined with chemo*
o Monitor BP for HTN
o Might need sign on door -> no palpating the abdomen
o Avoiding overwhelming family
o Explain benefits and side effects of treatment
o Support the family
◉ Retinoblastoma: Etiology/Diagnostics
Answer: -Arises from the retina. RB gene
o Caused by mutation in a gene
-May be sporadic or inherited
o Diagnosis at 2 years
◉ Retinoblastoma: S/S
Answer: o Cat Eye's reflex- whitish glow of the pupil (Leukocoria)
o Strabismus: crossed eyes, don't look the same way but doesn't
always have cancer
o Heterochromia: two different color pupils
,o Clean wound with little to no drainage
o Direct visualization with ophthalmoscope
o CT
o MRI
◉ Retinoblastoma: Treatment & Interventions
Answer: o Radiation
o Chemo
o Cryotherapy: freezing
o Enucleation: removal of the eyeball**
o Teach: Sphere will be placed**, covered with mucosal lining
(will resemble oral cavity) After surgery: face will be edematous,
bruised, patch to cover eye (only slight drainage), will be fitted for
prosthesis in 3-4 weeks
o Eye patch -> To protect from infection and security from fingers
o Encourage parents to see site ASAP
o Socket care
- Only remove fake eye to clean
◉ Grief and Loss: important
Answer: Thoughts and responses from each age group: nursing
interventions to meet the child's needs. Always be honest and
accurate
, ◉ Grief and Loss: Infants
Answer: Death has the LEAST significance on children under 6
months after trust is established, loss is profound
◉ Grief and Loss: Toddlers
Answer: Egocentric can only see from their point of view.
Doesn't comprehend death well, more affected by a change in
their lifestyle. They feel the absence
◉ Grief and Loss: Preschoolers
Answer: Death is temporary to them. They believe their thoughts
can cause death. They don't have a great understanding. Keep
same routine and same caregivers
"Caused the illness" "is this heaven"
Person is "sleeping" **
◉ Grief and Loss: School Age
Answer: -Associate misdeeds with death, monster, fear, cruel
Fear of the unknown is greater than the fear of known
◉ Grief and Loss: Adolescents
Answer: Mature understanding
Have the MOST difficulty coping because they know its
irreversible.
ANSWERS GRADED A+
◉ Ewing Sarcoma: Treatment & Interventions
Answer: o Radiation
o Chemo
o Possible limb salvage/amputation
◉ Wilms tumor (nephroblastoma): Etiology/Diagnositcs
Answer: Tumor in the kidney. DON'T PALPATE** Will rupture and
SPREAD CANCER**
BEST prognosis in childhood cancers, 2-3 years of age
o CT, MRI, U/S of abdomen
◉ Wilms tumor (nephroblastoma): S/S
Answer: o Painless firm mass in abdomen deep in the flank area,
conned to one side**
o Hematuria
o Confined to one side
o Weight loss, anorexia
o Fever
o HTN (maybe)
,o Anemia
o Lymphadenopathy: swollen lymph nodes
o Painless swelling
o Pallor
◉ Wilms tumor (nephroblastoma): Treatment & Interventions
Answer: o Surgery combined with chemo*
o Monitor BP for HTN
o Might need sign on door -> no palpating the abdomen
o Avoiding overwhelming family
o Explain benefits and side effects of treatment
o Support the family
◉ Retinoblastoma: Etiology/Diagnostics
Answer: -Arises from the retina. RB gene
o Caused by mutation in a gene
-May be sporadic or inherited
o Diagnosis at 2 years
◉ Retinoblastoma: S/S
Answer: o Cat Eye's reflex- whitish glow of the pupil (Leukocoria)
o Strabismus: crossed eyes, don't look the same way but doesn't
always have cancer
o Heterochromia: two different color pupils
,o Clean wound with little to no drainage
o Direct visualization with ophthalmoscope
o CT
o MRI
◉ Retinoblastoma: Treatment & Interventions
Answer: o Radiation
o Chemo
o Cryotherapy: freezing
o Enucleation: removal of the eyeball**
o Teach: Sphere will be placed**, covered with mucosal lining
(will resemble oral cavity) After surgery: face will be edematous,
bruised, patch to cover eye (only slight drainage), will be fitted for
prosthesis in 3-4 weeks
o Eye patch -> To protect from infection and security from fingers
o Encourage parents to see site ASAP
o Socket care
- Only remove fake eye to clean
◉ Grief and Loss: important
Answer: Thoughts and responses from each age group: nursing
interventions to meet the child's needs. Always be honest and
accurate
, ◉ Grief and Loss: Infants
Answer: Death has the LEAST significance on children under 6
months after trust is established, loss is profound
◉ Grief and Loss: Toddlers
Answer: Egocentric can only see from their point of view.
Doesn't comprehend death well, more affected by a change in
their lifestyle. They feel the absence
◉ Grief and Loss: Preschoolers
Answer: Death is temporary to them. They believe their thoughts
can cause death. They don't have a great understanding. Keep
same routine and same caregivers
"Caused the illness" "is this heaven"
Person is "sleeping" **
◉ Grief and Loss: School Age
Answer: -Associate misdeeds with death, monster, fear, cruel
Fear of the unknown is greater than the fear of known
◉ Grief and Loss: Adolescents
Answer: Mature understanding
Have the MOST difficulty coping because they know its
irreversible.
