NURS 225 Midterm: Peds Open Book Exam 1 Notes
Pediatric Oncology and Cardiac
Oncology
1) Presentation
a) Pain-result of neoplasm directly or indirectly affecting nerve receptors
through obstruction , inflammation, tissue damage, stretching of visceral
tissue or invasion of susceptible tissue
b) Cachexia-anorexia, weight loss, anemia, asthenia (weakness), and early
satiety
c) Anemia
d) Infection
e) Bruising and petechiae
f) Neurologic symptoms-increased intracranial pressure, change in
consciousness, etc.
g) Palpable mass
2) Diagnostic Tests
a) CBC with differential
b) Bone marrow aspiration
c) Bone marrow biopsy
d) Lumbar puncture
e) Peripheral blood studies
f) Radiographic examination
g) MRI
h) Computed tomography (CT)
i) Ultrasound
j) Biopsy of tumor
3) Liquid tumors-cancer of the blood or lymphatic system
a) Leukemia-Proliferation of abnormal white blood cells in the body
(leukocytes)
i) Clinical manifestations-fever, pallor, overt signs of bleeding, lethargy,
malaise, anorexia and large joint/bone pain
ii) Lymph nodes: > 1cm in axillary, >2 cm anywhere; for supraclavicular
nodes rule out mediastinal or abdominal mass
iii) Labs-
(1) WBC-greater than 10,000/mcL
(2) Platelets-20,000-100,000/mcL
(3) Hemoglobin-7-11 g/dL
iv) Acute Lymphoblastic Leukemia (A.L.L.)-most common
(1) Affects T and B lymphocytes
v) Acute Myeloid Leukemia (A.M.L.)
(1) Affects monocytes, erythrocytes, platelets
b) Lymphoma-Malignancy that presents in spleen, lymphatic system
i) Hodgkin’s-non-tender, firm lymphadenopathy supraclavicular and
cervical nodes and mediastinal area; lymph node biopsy reveals Reed-
Sternberg cells
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