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pediatric nursing exam 1
sf state semester 3 pediatric nursing
20
Medical
Undergraduate 3
03/22/2006

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Cards

Term
What tissues are likely to be affected by leukemia?
Definition
Highly vascularized organs: liver, spleen, lymph, bone marrow
Term
What are some S/S of leukemia?
Definition
profound anemia
infection with left shift (increase in
immature neutrophils)
bleeding (petechiae anywhere that clothing
tight)
Term
What is the pathophysiology of leukemia?
Definition
Unrestricted proliferation of immature WBCs that act like a "circulating tumor" and can send out "fingers" into different organ systems and then compete for metabolic elements causing destruction to tissue around it.
Term
With leukemia, what would you see in a complete WBC count?
Definition
Leukocytosis (increased WBC count >10,000) with very low percentage of mature WBCs
Term
What is the end result of leukemic invasion of spleen, liver, and lypmph glands?
Definition
hepatosplenomegaly and fibrosis
Term
What is a possible cause of pathological fractures?
How?
Definition
Leukemia
Invading leukemic cells into bone marrow causes weakening
Term
What is the chemotherapy Tx for acute lymphoid leukemia?
What is the goal?
Definition
4-6 weeks
corticosteroids, vincristine, L-aspariginase and maybe doxorubicin
goal: remission or decrease cells to 5%
Term
What is the chemotherapy Tx for AML (ANLL)?
Definition
doxorubicin
daunomycin
Term
What are 3 Tx's for leukemia?
Definition
chemotherapy
steroids
hematopoietic stem cell transplantation (bone marrow transplant)
Term
What are the 3-5 phases of chemotherapy for leukemia?
Definition
1)Induction therapy lasts 4-6 wks. Goal is to put into remission or decrease cells to 5%
2)Intesification therapy: after remission, Tx is intensified to eradicate remaining leukemic cells
3)Maintenance: daily and weekly IV,IM, and intrathecal meds for 2 yrs
4)Possible CNS prophylactic therapy
5)Possible relapse induction
Term
Why are steroids part of Leukemia Tx?
Definition
stop bone marrow from producing WBCs
counteract inflammation from chemo
Term
What therapy is only for high risk leukemia Pts? Explain.
Definition
CNS prophylactic therapy:
intrathecal methotraxate and cytarabine
*injected into spinal column so X's blood-brain barrier for pts who have plaques in CSF or brain
*it can kill Pts, so needs lots of checks
Term
Who must be in the room during CNS prophylactic therapy for leukemia Pts?
Definition
If the parent cannot handle being in the room, a play therapist or someone the child trusts must be there to help/hold hand/distract child
Term
What factors would indicate a better prognosis in a leukemia Pt?
Definition
*Normal or low initial WBC count
*Onset at 2-9 yrs rather than before 2 or after 10
*female
*DNA index >1.16 and translocation of chromosomes 4 and 10
Term
What are chemotherapy drugs?
Definition
antimetabolites that affect fast proliferating cells such as hair, nail, GI, bone marrow cells
Term
What are some relatively immediate side effects of chemotherapy?
Definition
alopecia, sores in GI tract from mouth to anus, GI bleeds, gastric pain, vomiting blood, lines on nails
Term
What pain medication is needed to deal with the side effects of chemotherapy?
Definition
Morphine drip
Term
What is Nadar?
Definition
Period of 7-12 days after chemotherapy when there is pancytopenia (wiped-out bone marrow) and sometimes no WBCs which means the chemo is working.
Term
What are some late side-effects of cancer Tx?
Definition
*anthracycline causes *chemo and radiation effect all organs negatively (e.g. brain growth effected and interferes in cognitive development)
*secondary malignancy-lymphoma
*cranial radiation before 5:risk malignant brain tumor cardiomyopathy
*intrathecal chemo->cognitive delays
Term
What do parents need to be aware of during chemotherapy?
Definition
*pathology
*S/S of sepsis - if worried bring in, especially duing nadar
*drugs and side effects
*when to seek emergency medical help
*how to optimize growth and development
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