NURS 2356/2355 Oncology, Cancer in Pediatrics, - Exam 2 (Onc/MS/Cardio) with Correct Answers

Retinoblastoma Correct Answer congenital,Intraocular malignant tumor of the retina 1-2 yrs old Autosomal Dominant/ chromosomal mutation Serial exams q2-3 months til 2, 4 months til 3, then annually Increased risk of developing secondary tumor - Tumor of eye Planning & Implementation for Wilm's Tumor Correct Answer Postrenal surgery phase: focus on pain & monitoring fluids Minimize infections-> hygiene -> S/S UTI-> pylonephritis Chemotherapy Phase: monitor for S/E of drugs Strict I&O Renal Dosing Daily Weights Gentle handling of child Diagnostics for Wilm's Tumor Correct Answer 1. CXR (for mets) 2. CT (abdomen, chest) 3. US (abdomen) 4. Definitive (made at time of surgery) 5. Labs → U/A, CBC, Lytes, Liver, & Renal function Dx: US, IVP, labs, spyrosplice CT & MRI for metatsis S/E for Radiation Therapy Correct Answer - Breaks DNA molecules & destroys all cells - ↓ growth of bone & teeth - N&V, Anorexia, Fatigue Effects can last long after radiation impaired bone & teeth -Severity of side effects are dose related what are the s/e's of radiation Correct Answer •Erythema within the radiated site •Fatigue =common side effect - need frequent rest periods •Similar side effects as chemotherapy =Anorexia, nausea, vomiting, diarrhea, dermatitis •May cause bone marrow suppression -depending on the dose & site of Rx REVIEW OF BONE TUMORS Correct Answer • Tend to occur in long bones (both types occur here) • But Can occur in any bone in the body • Pain in the limb is the most common symptom •May limp • Both sexes affected equally until puberty then there is a 2:1 ratio in favor of males • But the treatment is different! Where are the primary tumor sites for Ewing Sarcoma? Correct Answer Diaphysis of long bones of the extremities and flat bones of the trunk (arms/legs, vertebrae, scapula, ribs, pelvic, skull) - Shaft portion of long bones (femur, tib/fib, ribs, pelvis, humerus, vertebrae) • bones of the arms & legs, vertebra, scapula, ribs, pelvic & skull bones S/s of Ewing's Sarcoma Correct Answer "Bone CA" 1. Pain 2. Soft tissue swelling around affected bone 3. Fever 4. Mets- s/s depend on location (anorexia, malaise, fatigue, wt loss, neuro s/s if in vertrbra, resp s/s if in ribs) 5. - ↑ WBC, ↑ CRP, ↑ sed rate Vertebral-> Neurological Signs Ribs-> Respiratory Compromise ewing; radiation Correct Answer Ewing Sarcoma - Responds well to radiation Radiosensitive-high doses of radiation are used •may also be combined with chemotherapy •Newest Modes of Treatment - To use chemotherapy to .J, tumor size followed by surgery or radiation osteosarcoma ; radiation Correct Answer Osteogenic Sarcoma - Radioresistant •Doesn't respond to radiation therapy •Surgical removal & chemotherapy are used 90% relapse with surgery alone Nsg Assessment, Planning/Implementation for Ewing's Sarcoma is... Correct Answer Is the same as Planning/Implementation for Osteosarcoma 1. Check site before surgery (redness, swelling, pain) 2. Assess mobility & gait 3. Look for systemic Sxs (w/mets) 4. Post-Op care/assessments (hemorrage,infection, pulses) 5. Phantom limb pain; treat w/meds!! 6. Psychological- Depression, disturbed body image Treatment for Ewing's Sarcoma Correct Answer 1. Chemo 1st ↓ to size 2. Surgery to remove 3. Radiation - Chemo, surgery, then radiation - Extremity may be amputated