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PEDS NR 328 Cumulative Exam 2023- Chamberlain College $19.99   Add to cart

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PEDS NR 328 Cumulative Exam 2023- Chamberlain College

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PEDS NR 328 Cumulative Exam 2023- Chamberlain College PEDS NR 328 Cumulative Exam 2023- Chamberlain College PEDS NR 328 Cumulative Exam 2023- Chamberlain College PEDS NR 328 Cumulative Exam 2023- Chamberlain College PEDS NR 328 Cumulative Exam 2023- Chamberlain College PEDS NR 328 Cumulative Exam 2...

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  • August 29, 2023
  • 18
  • 2023/2024
  • Exam (elaborations)
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Chapter 25: Cancer

Neoplastic Disorders:
Types
 Leukemias (most common)
o Acute lymphocytic leukemia (ALL)
o Acute Myelogenous Leukemia (AML)
 Lymphomas
o Hodgkin’s and non-Hodgkin
 Solid tumors

Childhood Cancer:
Epidemiology:
 Rare
Etiology:
 Genetic events (5%)
o Problems with DNA itself
o Syndromes can  risk
 Two-hit hypothesis
o Healthy gene will override unhealthy gene
o Two toxic genes will present in cancer
Risk Factors:
 Little information on environmental role
 Radiation, carcinogens, infections, syndromes
Prevention:
  sun exposure, radiation exposure and smoke
 Early identification is key
Cardinal Symptoms:
 Unusual mass or swelling
 Paleness, loss of energy
o Lots of napping
 Bruising
o Leukemia
 Persistent localized pain or limping
o Limping, bone pain
 Prolonged, unexplained fever or illness
o Continual colds, challenge to recover
 Frequent headache with vomiting
o Worse in the morning d/t ICP

, Sudden eye or vision changes
o Linked with tumor in brain
 Excessive rapid weight loss
o Most cancers
Treatment:
 GOALS: cure of patient &  SE of medicaitons
 Surgery
o Removal of tumors
o Biopsys
 Chemotherapy
o Most cancers
o Handling Chemo:
 Chemo gloves
 Disposal: double flushing and covering lid
 Specific BINS for chemo
 Use PPE (chemo gown, gloves, goggles, masks)
 Specific linen bag
 Crush meds in closed container
 Sweat, urine and other bodily fluids can expose you to chemo**
educate the parents!
o Managing Chemo:
 Vesicants: cause tissue death
 ** interventions for extraversion**
 Stop med, notify Dr. & pharmacy (don’t flush)
 Do not pull IV until PO
 Risk for anaphylaxis
 Hives, itchy, redness, VS changes, back pain, resp
 EPI

 Biological Therapies
 Radiotherapy:
o Causes cell death via radiation
o S/E:
 Skin burns  peeling and cracking skin
 Bone Marrow Transplantation:
Side Effects of Treatment:
 Infection:
o Chemo suppresses immune system
o Nursing considerations: school and NO large groups, wearing masks

,  Hemorrhage:
o Epistaxis’s and gingival bleeding are the most common (nose and gum,
heavy periods )
o Activity restricitons but still want the kid to be active in a safe manner
 Anemia:
o O2 &  work of breathing & heart
o Can be fatigued
o Regular CBC
 Nausea and Vomiting
o Tx 30-45mins before (Zofran) and for 24-48 hours after
TOXIC SIDE EFFECTS:
 N/V
o Extreme care for nutrition d/t GROWTH
o Don’t give child favorite foods
o Small frequent meals
o Water
 Anorexia
o Stimulants (cannibas)
 Mucosal ulcerations (can be whole GI tract) (d/t chemo targeting rapid
replicating cells)
o N/V can make it much worse
o Magic mouthwash
o Pain management prior to meals
 Neuropathy
o Foot drop
o Fall risk
o Boots
o Causal Rx: VINCHRISTINE
 Hemorrhagic cystitis : bleeding in the bladder**
o Causal RX: Ifosphamide & Cyclophosphamide
 Give Rx in AM
 Given with MESNA (bladder protective)
 Frequent UA to assess for bladder
 EXTRA FLUIDS to help flush
o Mucous membrane in bladder
o Impossible to reverse, permanent damage to bladder
 Alopecia
o Considerations: Reassure pt it will grow back & discuss before

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