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NUR254 EXAM 4 PEDS STUDY GUIDE NOTES
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NUR254 EXAM 4 PEDS STUDY GUIDE NOTES
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lOMoARcPSD|45707609NUR254 EXAM 4 PEDS STUDY GUIDE NOTES
, lOMoARcPSD|45707609
Child cCaring cExam c#4 cStudy cGuide
Nur c254 cPediatric
cExam c4 cGalen cCollege
cof cnursing
Unit c9: cOncology, cHematology, cGrief, cand cLoss
• Nursing cmanagement
o Communication
▪ Appropriate cresponses cfollowing cdeath cof ca cchild c(therapeutic ccommunication)
• Stay cwith cthe cfamily
• Accept cthe cfamily’s cgrief creactions cand cavoid cjudgmental cstatements
• Avoid c“rationalizing” c(She cisn’t csuffering canymore)
• Avoid cartificial cconsolation c(“I cknow chow cyou cfeel”)
• Do ceverything cpossible cto censure ccomfort
• Express cpersonal cfeelings cof closs cor cfrustration c(you ccan ccry!)
• Allow cfamily cto cstay cwith cchild cas clong cas cneeded
• Refer cto cthe cdead cchild cby cname
o Recognizing csigns/symptoms
▪ Impending (everything cslows cdown)
cdeath• Loss cof csensation cand cmovement cin clower cextremities c– cprogresses ctowards cupper cbody
• Sensation cof cheat, calthough cbody cis ccold
• Loss cof csenses c(photosensitivity, ctactile csense cdecreases)
• Confusion, closs cof cconsciousness, cslurred cspeech
• Muscle cweakness
• Loss cof cbowel cand cbladder ccontrol
• Decreased cappetite cand cthirst
• Difficulty cswallowing
• Change cin crespiratory cpattern c(Cheyne-Stokes crespirations)
• Weak, cslow cpulse
• Decreased cBP
o Creating ccare cplans
▪ Leukemia= c(involves cblood ccells cand cbone cmarrow) ctoo cmuch cWBC cNot cenough cRBC cfor cclotting
• Acute clymphocytic cleukemia c(ALL)
▪ Most ccommon c(2-5year cold)
• Acute cmyelogenous cleukemia c(AML)
▪ Higher crate cin cinfants
• S/S: cgenerally, cthere care cfew c“dramatic” csigns cand csymptoms
▪ Diagnosis ccan coccur cwhen ca ccold cfails cto cgo caway
▪ Weight closs, cpetechia, cbruising, ccomplaints cof cbone cor cjoint cpain, cfatigue, canemia,
cunsteady cgait, cthrombocytopenia
▪ Immature c“baby” cWBC
▪ Labs: clow cH&H cand clow cPlatelets
• Neutropenic cprecautions cand cbleeding cprecautions
▪ Private croom
▪ All cvisitors cwear ca cmask c– cNO csick cvisitors
▪ Hand chygiene
▪ WE care ca cthreat cto cthe cchild, cnot cthe cother cway caround
▪ No cfresh cflowers
▪ Thoroughly ccooked cfoods
• Treatment= cradiation c& cchemo
▪ Induction cphase
▪ Low clevel cchemo cfor c4-5 cweeks
▪ Intensification cphase
▪ “pulses” cof cchemo cover c6 cmonths
▪ Maintenance ctherapy
▪ Combined cdrugs cto ckeep cin cremission cfor c2-3 cyears
▪ Bone cmarrow ctransplant
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