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Peds Unit 2 - Onc

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olanjones's version from 2017-02-22 04:25

Oncology

Question Answer
Incidence in childrenRare but most common types: Leukemia, Brain & CNS Tumors, Lymphomas, Kidney (Wilms) Tumors
Brain Tumors AssessmentHA in a.m., Projectile Vomiting, Neurologic function (r in reflexes, gait, speech, seizures)
Effects of brain tumordepend on where it is located (eg. back of head- dreams)
BT InterventionsPreparation for CT or MRI, radiotherapy, chemotherapy, surgery; Post-surgical care
Hodgkin’s Lymphomabegins in lymph nodes (inflame. caused by cytokines released from Reed-Sternberg cells), can be extranodal (most common: lung, liver, bones, & bone marrow)
Non-Hodgkin’s Lymphomacancer of lymph system - proliferation of B or T lymphocytes, Respiratory obstruction.
Hodgkin’s Assessmentpainless adenopathy of supraclavicular & cervical nodes, unexplained fever (temp h38.0°C oral), unexplained weight loss (10% of body weight w/in 6 mos), & drenching night sweats
Non-Hodgkin’s AssessmentTrouble breathing/swallowing, swelling of head, neck, upper body, or arms, fever, weight loss, night sweats
Wilm’s Tumor OverviewNephroblastoma- embryonic cancer of kidney, originates in fetus, usu only 1 kidney. Excellent prognosis if no metastases
WT Assessmentabdominal pain, blood in urine, anemia, constipation, high BP
WT InterventionDON’T PALPATE ABDOMEN, child will have nephrectomy
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Leukemia

Question Answer
Blast cells areNonfunctional, cannot fight infection, multiply continuously
S/S of anemia & bleeding disordersBlast cells invade bone marrow leading first to hypertrophy and then to atrophy of the bone marrow & reduction in all blood cells: causes Anemia, Bleeding disorders, Immunosuppression
Early signbone pain
Acute Lymphoid Leukemia (ALL)Most common, Peak age is 2-5 years, 90-95% achieve 1st remission; about 80% live 5 years. Death usually follows overwhelming infection
Acute Myelogenuous Leukemia (AML)More common than ALL in adolescents, 50-70% of adolescents reach 1st remission; 40% live 5 years. Death usually follows overwhelming infection
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Death and Dying

Question Answer
ToddlerNo concept of time or place. Don’t want to be separated from parents
Preschoolermagical thinking, they think death is a temporary sleep
School-ageunderstand permanence, may be curious about it. Fear separation or abandonment
Adolescentunderstand and may cope well or not cope well. May be ok with making plans.
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