CH. 52 - Chipola College
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Transcript CH. 52 - Chipola College
Nursing Care of the Child
With Cancer
Neoplasia
Cell growth in cancerous tissue proliferates
in disorderly and chaotic ways
Neoplasm- literally “new growth,” but usually
refers to abnormal new growth
ASSESSING CHILDREN WITH
CANCERS
History
Physical and laboratory examination
Biopsy
Bone marrow aspiration
OVERVIEW OF CANCER TREATMENT
MEASURES USED WITH CHILDREN
Radiation therapy
Immediate side effects
Long term side effects
OVERVIEW OF CANCER TREATMENT
MEASURES USED WITH CHILDREN
Chemotherapy
Chemotherapy protocols…no ASA, no live
viruses, no folic acid
Side effects & toxic reactions
Hair loss and N&V are common
Also malnutrition, stomatitis, constipation, and diarrhea
OVERVIEW OF CANCER TREATMENT
MEASURES USED WITH CHILDREN
Bone Marrow transplantation
Can be autologous or allogenic
Hematopoitic Stem Cell transplant
Autologous, peripheral
Stored umbilical cord blood
Embryonic?
THE LEUKEMIAS
Leukemia-uncontrolled proliferation of WBCs
and the most common childhood cancer
Acute Lymphocytic Leukemia
75% of leukemias fall into this category
Overproliferation of lymphocytes
S/S
Pallor, low-grade fever, lethargy
Goal
Total cure, 95% of children will have a first remission
but if they experience a relapse, the prognosis is less
favorable
THE LEUKEMIAS
Acute Myelogenous Leukemia
Accounts for 20% of leukemias
Overproliferation of granulocytes
S/S are the same as with ALL but may also have
had recent URIs
Goal
Remission is harder to achieve than in ALL and tends to
be shorter
THE LYMPHOMAS
Malignancies of the lymph or
reticuloendothelial system
Hodgkin’s Disease
Reed-Sternberg cells
S/S
One painless, enlarged, rubbery-feeling lymph node,
usually cervical
Therapeutic Management
Chemo and radiation
90% 5-year survival rate and relapses respond well the
further therapy
THE LYMPHOMAS
Non-Hodgkin’s Lymphoma
Proliferation of lymphocytes
Spread through the bloodstream rather than by
lymph flow
S/S
Enlargement of lymph nodes of neck and chest
Therapeutic Management
Chemo and autologous bone marrow transfusion
80-90% of those with minimal symptoms will achieve
remission
Non-Hodgkin’s Lymphoma
Burkitt’s lymphoma
Rare form of Non-Hodgkins
Associated with the Epstein-Barr virus that causes
mononucleosis
S/S
• Enlarged lymph node in the neck or abdomen
Therapeutic Management
• Surgery, then chemo
NEOPLASMS OF THE BRAIN
Types of Brain Tumors
Astrocytomas
Medulloblastomas
Brain stem tumors
S/S
Symptoms of increased ICP
Headache, vomiting, vision changes, enlarging head
circumference
Therapeutic management
Surgery, then chemo and radiation
BONE TUMORS
Osteogenic Sarcoma-malignant tumor of the
long bone
S/S
Pain and swelling, esp. around the knee
Therapeutic Management
Surgery, usually amputation, then chemo
60-65% of those rigorously treated can be cured
Ewing’s Sarcoma-occurs most often in the bone
marrow of long bones
S/S is pain
Therapeutic Management is surgery, radiation,
and chemo
OTHER CHILDHOOD NEOPLASMS
Neuroblastoma
Tumors that arise from the cells of the
sympathetic nervous system
The most common abdominal tumor in childhood
S/S
Palpable abdominal mass
Therapeutic Management
Depends on staging
Surgery, chemo, bone marrow transplant
Overall survival rate is 70-90%
OTHER CHILDHOOD NEOPLASMS
Rhabdomyosarcoma
Tumor of striated muscle
S/S depend on site
Therapeutic Management
Surgery, then chemo
Prognosis depends on size and location of tumor
OTHER CHILDHOOD NEOPLASMS
Wilm’s tumor- malignant tumor that rises from
the metanephric mesoderm cells of the upper pole
of the kidney
Accounts for 20% of solid tumors in childhood
Associated with aniridia, cryptorchidism, hypospadias
S/S
Firm, nontender, abdominal mass
Therapeutic Management
Abdominal palpation seems to increase metastasis
Surgery, radiation, chemo
OTHER CHILDHOOD NEOPLASMS
Retinoblastoma-malignant tumor of the retina of
the eye
Accounts for only 1-3% of childhood
malignancies
Associated with an alteration of chromosome 13
and also an inherited autosomal dominant pattern
S/S
Absence of red reflex in the pupil then later, strabismus
Therapeutic Management
Cryosurgery for small tumors, enucleation for large
ones