question

-ages 20 & younger -kids don't have the protein-binding ability because the muscles are beginning to grow -kids have quicker metabolic rate, going thru growth & development, need more fluid, smaller fat content -may have problems with infertility & cognitive functioning--depending on cancer & chemo

answer

Childhood Cancers

question

what are lasting effects of the cancer & chemo children hospitals--specialties higher risk of cancer return, or to get another cancer chemo affects the kidneys, lungs, & heart; chronic conditions

answer

Cancer Chart Slide

question

Wilms' Tumor Retinoblastoma Osteosarcoma Aplastic anemia Acute lymphobastic leukemia Ewing Sarcoma -most likely tested on -rare, but will see them as childhood cancers -96% favorable: more responsive to tx & have a better prognosis -93% unfavorable: large, distorted

answer

6 Cancers in PowerPoint

question

-nephroblastoma -named after Max Wilms in 1899 -often on the left kidney (but can be both kidneys) -slightly more common in girls -1 in 10,000 -peaks at age 3-4 -National Wilms Tumor Study good outlook for this tumor complicated to treat this cancer if unfavorable encapsulated in a thing, fragile covering, really easily torn -can cause cancer to spread into body can be favorable or nonfavorable-depends under a microscope

answer

Wilms' Tumor

question

Stage 1: involves one kidney and removable with surgery Stage 2: extends beyond one kidney but can be completely removed with surgery Stage 3: cannot be completely removed beyond the one kidney but stays within the abdominal cavity Stage 4: metastasis to other organs Stage 5: involves both kidneys kidney dysfunction later, ex: renal failure kidneys affected: adrenals, BP, intra & extracellular fluid, dehydration, & cardiac problems may have increased or decreased BP than normal, changes when they change positions. Sx similar to shutting of SNS--anxious, can't sleep, losing weight, reved up all the time.

answer

Wilms' Tumor Staging

question

Sx -abdominal mass -abdominal pain -fever -hematuria usually ages 2-4 years upper left quadrant pain do not palpate, could rupture the capsule Diagnostic -ultrasound -CT -MRI -angiography of renal veins

answer

Wilms' Tumor Clinical Symptoms Diagnostic Tests

question

avoid palpation of the abdomen surgical removal chemotherapy -stages 1-3: actinomycin D and vincristine -stages 3-5: doxorubicin, cyclophosphamide, etoposide and radiation understand meds: name, category, nadar, unique sx Stages 1-3: helps the cell stop dividing, but stops healthy cells too; sensitivity to light Stages 3-5: can be cardiac sx and can cause hemorrhagic cystitis. can be higher risk for kidney and heart problems as they age. vincristine: can cause hemorrhagic cystitis, mesna is antidote. increase fluids to filter out the kidneys.

answer

Wilms' Tumor Medical Management

question

does run in families parents usually catch when they are holding their infants & the light hits their eye a certain way.

answer

Retinoblastoma

question

a malignant glioma of the retina usually unilateral occurs in young children frequently hereditary and known as germinal retinoblastoma (40%) can't find red reflex have white circle instead higher risk for developing other cancers x-ray will show it the smaller the tumor, the better the outlook.

answer

Retinoblastoma What is it

question

leukocoria or cat's eye reflex strasbimus red painful eye inward or outward turning of the eye visual impairment two different colored iris (heterochromia) won't be able to perform cranial nerve assessments if caught early, child may just have minimal vision problems. always investigate reason for 2 different colored eyes

answer

Retinoblastoma Symptoms

question

Grade A: small tumor located in retina; no seeding or detachment <3 mm Grade B: small tumor located in retina; no seeding or detachment <5 mm Grade C: localized seeding and some detachment Grade D: massive seeding and retinal detachment Grade E: no visual potential seeding=metastasize optic nerve is needed for sight

answer

Retinoblastoma Staging

question

high beam radiation therapy: Cobalt 60, Radioactive Iodine 125 Cryotherapy for very small tumors Chemotherapy: carboplatin, vincristine, etoposide Enucleation (eye removal) after exhaustion of other treatments experimental injection of melphalan into ocular artery chemo does effect nervous system, could cause neuropathy enucleation used to do this often, not so much anymore melphalan interacts with guanine, kills cells, even healthy ones may have nystagmus (darting) or a lazy eye the rest of their life some cryotherapies are toxic to the kidneys could have renal failure, cardiac failure, and nervous system problems

answer

Retinoblastoma Medical Management

question

Tibial tuberosity: where the leg bones grow the quickest unusual, large, shiny area over a couple days=osteosarcoma end of the long bone=common cancer cells invade the bone structure, and crowd out all the normal cells becoming a mass; spreads to tissues; causing pain 50% of tumors are right below the knee 400-500 cases/year may have pain up to 6 months before osteosarcoma is suspected.

answer

Osteosarcoma

question

sarcoma originating in the bone at the growth points; shins, upper arm, and thigh most often during puberty twice as likely in boys familial retinoblastoma results in higher risk of osteosarcoma

answer

Osteosarcoma What is it

question

Sx -swelling upon flexion -night pain -shiny skin over tumor -cardiomyopathy Dx -CT -MRI -Biopsy -X-ray can be identified in athlete's when they are working out with weights heart muscles become affected if it metastasizes, worry about the lungs, kidneys, adrenals, and heart

answer

Osteosarcoma Symptoms Diagnosis

question

Chemotherapy -methotrexate -doxorubicin -cisplatin -ifosfamide -etopiside Amputation -only when necessary -limb sparing surgery where bone is replaced with a prosthetic or with bone from another area of the body Methotrexate is becoming a hallmark chemo agent; also used for rheumatoid arthritis and auto-immune diseases, stops the cell when it needs folic acid to divide amputation: used to do a lot of them body image issue may occur cisplatin: worry about ototoxicity, kidney toxicity, and cardiac toxicity methotrexate: two dose limiting factors: elevated liver enzymes and arachnoiditis (seizures and headaches)

answer

Osteosarcoma Treatment

question

unique, all cells affected in bone marrow 4-5 cases per billion see a lot of immature RBC higher risk for infection, decreased WBC lower tissue perfusion, fatigue, pallor, SOB, decreased RBC

answer

Aplastic Anemia

question

also called pancytopenia or hypoplastic anemia suppression of the bone marrow of RBCs, WBC, and platelets RBCs are the last to show reduction in numbers more common in Asia hereditary form--Fanconi's anemia Acquired form--autoimmune disease 80% of cases acquired form; also exposed to environmental toxins: industrial chemicals Ex: benzene, arcinic; medications, ex: Dilantin, peridium

answer

Aplastic Anemia What is it

question

Sx -fatigue -SOB -rapid/irregular heart rate -pallor -frequent and prolonged infections -unexplained/easy bruising Dx -CBC -Bone marrow aspiration losing O2 ability=tachycardia

answer

Aplastic Anemia Symptoms Diagnosis

question

remove underlying cause if environmental RBC transfusions platelet transfusions bone marrow transplant immunosuppression: steroids, cyclosporine, antihymocyte globulin (thymoglobulin) to do bone marrow transplant, need to suppress immune system to reduce the risk of rejecting new bone marrow

answer

Aplastic Anemia Medical Management

question

stem cell transplant to rebuild the bone marrow with stem cells from a donor may offer the only successful treatment option for people with severe aplastic anemia immunosuppressant for people who can't undergo a bone marrow transplant or for those whose aplastic anemia may be due to an autoimmune disorder bone marrow stimulants may help the bone marrow to produce new blood cells. Growth factors are often used in combination with immune-suppressing drugs. can try give erythropoietin to build more RBCs possibly treat aplastic anemia

answer

Aplastic Anemia more info

question

WBC get over-run 80% of leukemias they don't differentiate between the WBC, RBC, and platelets

answer

Acute Lymphoblastic Leukemia

question

develops when there is an abnormal "error" in WBC production in the bone marrow cells allowing cells to keep dividing resulting in a large number of immature, lymphoblast (leukemic) cells which severely outnumber other blood cells. big blue cells in pathology=classic sign

answer

ALL

question

lymphoblasts crowd out RBCs and platelets lymphoblasts cross the blood-brain barrier as the RBCs die, the spleen and liver become engorged with cellular debris accounts for 80% of leukemia cancers peak age is at 2-3 years highest incidence in Hispanic children 95% remission rate usually a bone marrow transplant to cure

answer

ALL What is it

question

Change in bowel or bladder habits A sore that doesn't heal Unusual bleeding or discharge Thickening or lump in breast, testicles, or elsewhere Indigestion or difficulty swallowing Obvious change in size, color, shape or thickness of wart, mole, or mouth sore Nagging cough or hoarseness

answer

CAUTION s/s of cancer

question

bleeding bone pain infections fatigue swollen lymph nodes bone marrow can't keep up Important to note the swollen lymph nodes: the ones in the thoracic area-clavicular, axillary, inguinal: usually never swell otherwise

answer

ALL Symptoms

question

Chemotherapy -asparaginase -corticosteroids -cyclophosphamide -doxorubicin -methotrexate -cytarabine bone marrow transplant stem cell transplant tx option for kids who have a second remission after relapse: bone marrow transplant

answer

ALL Treatment

question

tx to cure some types of cancer, such as leukemia, lymphoma, and myeloma

answer

Stem Cell Transplant

question

three types: allogenic, autologous, synergeneic allogenic: collected from donor autologous: pt's own blood-forming stem cells Synergeneic: the donor is an identical twin

answer

Stem Cell Transplantation

question

Stem cells are harvested from the iliac crest or bloodstream thru apheresis umbilical cord blood is an additional source stem cells are frozen the recipient is given high doses of chemotherapy (cyclophosphamide and busulfan) to destroy existing bone marrow--this takes weeks

answer

Stem Cells Info

question

Stem cells are thawed and transfused to recipients stem cells travel to the bone marrow and establish themselves (engraftment); takes two to four weeks bone marrow becomes functional producing normal RBC, WBC, and platelets immunosuppressants are used to prevent graft-versus-host disease or stem cell rejection

answer

Stem Cell Therapy

question

tends to appear in middle bones, most often in femur, pelvis, ribs, upper arms, and thigh educate parents about s/s of infection. teach quiet activities that integrate normal developmental socialization

answer

Ewing Sarcoma

question

Represent one-third of all bone cancers in children chromosomes 11 and 22 abnormally exchange pieces (11:22 translocation) discovered by James Ewing in 1921 found in boys more than girls rare to be diagnosed after age 25 commonly 10-20 years of age nursing dx: impaired mobility dx: biopsy of bone lesion

answer

Ewing Sarcoma What is it

question

pain and swelling at tumor site bone pain or swelling respiratory distress spinal cord compression fever weight loss

answer

Ewing Sarcoma Signs and Symptoms

question

consists of 3 phases: Induction therapy: destroys leukemia cells in the blood and bone marrow and to attempt a restoration of normal blood cell production; 30 day treatment (lumbar punctures to inject intrathecally to prevent central nervous system involvement) Consolidation therapy: destroys remaining leukemia cells in the body; 4-8 month treatment Maintenance therapy: prevention of further leukemic cell production; 1-2 years of treatment

answer

Ewing Sarcoma Medical Management

question

Septic Shock Hemorrhagic Cystitis Superior Vena Cava Syndrome DIC Hyperleukocytosis and leukostasis Spinal Cord Compression Tumor Lysis Syndrome

answer

Oncological Emergencies

question

confusion fever tachypnea decreased urinary output cold clammy skin

answer

Septic Shock Signs & Symptoms

question

bloody or painful urination

answer

Hemorrhagic Cystitis

question

diminished blood return to the heart widening mass by the heart most common in lung cancers and Hodgkins lymphoma Increased ICP Sx: hoarseness, chest pain, difficulty swallowing, coughing up blood, swelling of veins in chest and neck, edema in arms, tachypnea, cyanosis

answer

Superior Vena Cava Syndrome

question

excessive thrombin generation due to sepsis or cancer common in leukemias common with use of asparaginase the proteins that control blood clotting become overactive S/S: chest pain, SOB, pain, redness, warmth and swelling, headaches, speech changes, paralysis, heart attack, lung and kidney problems

answer

DIC Disseminated Intravascular Coagulation

question

leukemias with counts higher than 100,000mm3 high counts cause sludging of the endothelial, bleeding and infiltrates in lungs hydroxyurea 1-3 grams every 6 hours S/S: coma, somnolence, altered mental status, agitation, seizures, papilledema, sluggish pupils, hypoxia, tachypnea, hemorrhage, thrombosis, hepatomegaly, splenomegaly, enlarged lymph nodes, priapism

answer

Hyperleukocytosis and Leukostasis

question

fast growing mass that occludes spinal cord neuroblastomas in children; breast and prostate cancers in adults pain in thoracic area location identifies how symptoms progress S/S: weakness of neck flexion, reflexes preserved, ptosis, ophthalmoplegia, variable feeding problems, generalized weakness, shallow rapid respirations, scoliosis

answer

Spinal Cord Compression

question

Metabolic abnormalities: -hyperkalemia -hyperphosphatemia -hypocalcemia -hyperuricemia most common in leukemias S/S: lethargy, nausea & vomiting, oliguria, flank pain, pruritus, tetany, and altered LOC. Prevention: keep urine alkalized and maintain a low phosphate diet. Nursing Care: aloprim, monitor electrolytes, sometimes dialysis is needed

answer

Tumor Lysis Syndrome

question

nausea & vomiting alopecia extravasation mucositis diarrhea & constipation anemia thrombocytopenia neutropenia

answer

Side Effects of Cancer Treatment

question

22% LIVE at least 30 yrs and don't suffer from chronic health problems 34% DIE within 30yrs, 20% die in years 1-5 14% DIE in years 6-30 19% SURVIVE at least 30 years but suffer life-long life-threatening or disabling chronic health conditions 25% SURVIVE at least 30 years but suffer mild or moderate chronic health conditions

answer

Chart on Slide 2

question

anthracycline antibiotic Nadir: 10-14 days after dose dose limiting cardiotoxicity; turns urine red

answer

Doxorubicin (Adriamycin) "red devil"

question

alkylating agent Nadir: 10-14 days after dose hemorrhagic cystitis--use MESNA

answer

Cyclophosphamide (Cyotoxan)

question

plant alkaloid Nadir: 7-10 days after dose peripheral neuropathy

answer

Vincristine (Oncovin)

question

plant alkaloid Nadir: 7-14 days after dose peripheral neuropathy; metallic taste; skin reaction

answer

Etoposide (Toposar)

question

alkylating agent nadir: 14-21 days after dose sensitivity to sunlight

answer

Actinomycin D (Dactinomycin)

question

alkylating agent nadir: 21 days after dose ototoxicity; nephrotoxicity; cardiovascular events

answer

Carboplatin (paraplatin)

question

alkylating agent nadir: 8-10 (WBC) 27-32 (platelets

answer

Melphalan (Phenylalanine mustard)

question

antimetabolite agent nadir: 10 days after dose hemorrhagic cystitis

answer

Methorexate (Rheumatrex)

question

alkylating agent nadir: 10-14 days after dose hemorrhagic cystitis

answer

Ifasfomide (Ifex)

question

enzyme nadir: 14 days after IM dose stomach cramping; central nervous system toxicity (seizures, hallucination)

answer

Asparaginase (Lspar)

question

antimetabolite nadir: 7-10 days (WBC) 7-15 days (platelets) hand-foot syndrome; eye sensitivity

answer

Cytarabine (Cytosar-U)

question

alkylating agent nadir: 14-21 days after pill dose adrenal insufficiency, busulfan lung-permanent lung damage and SOB

answer

Busulfan (Busulfex)

question

signal transduction inhibitor edema of feet, hands, and face; heart failure

answer

Imatinib (Gleevec: STI-571)

Childhood Cancer RAT – Flashcards

Unlock all answers in this set

Haven't found what you were looking for?

Search for samples, answers to your questions and flashcards