Lecture 22_ Oncology Part 2.docx - SLO\u2019s \u25cf compare and contrast clinical manifestations pathophysiology clinical treatment nursing management of

Lecture 22_ Oncology Part 2.docx - SLOu2019s u25cf...

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SLO’s compare and contrast clinical manifestations, pathophysiology, clinical treatment & nursing management of patients with common oncology problems Analyze medications & treatments for patients experiencing hematology & oncology problems Analyze the nursing process for patients with hematology/oncology disorders Identify pharmacologic interventions for patients with hematology/oncology disorders Lecture Content •Pediatric Solid Tumors •Breast Cancer •Lung Cancer •Prostate Cancer •Chemotherapeutics •Radiation •Biologic response modifiers (Biotherapy) •Bone Marrow Transplant •Application of the nursing process Solid Tumors in Children •Brain tumors •Neuroblastoma •Osteosarcoma •Ewing Sarcoma Brain Tumors •Most common solid tumors in children •Most common symptoms: HA (usual or unusual), n/v, visual disturbance - double vision/blurred vision, dizziness, vertigo, not always manifest sx, unusual sx - not baseline children vomiting for no reason cranial nerve dysfunction, sensory disturbances sx vary by person - location, type, how bad it is, etc. hard to access by surgery without encountering problems chemo - hard to access blood brain barrier → spinal column affects children & adults - can occur at any age can be benign or malignant → do tissue biopsy to determine even benign tumors can cause harm Brain Tumor: Diagnostic Evaluation Presenting clinical signs Neurologic evaluation MRI CT, EEG (electroencephalogram- electrical activity of brain), LP (lumbar puncture) Definitive dx based on tissue specimens obtained during surgery Gold standard = biopsy Brain Tumor: Therapeutic Management Depends on type of tumor Surgery Radiotherapy - kids will defer as long as possible to at least 3+ years old, A/E: radiation somnolence syndrome -cause slowed growth, low IQ
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Chemotherapy Prognosis Treatment of choice total removal of tumor w/o residual neurologic damage - ideal but depends on location of tumor may do chemo and radiation first to shrink to manageable size to do surgery Nursing Considerations Prepare patient and family for diagnostic and operative procedures Considerations related to body image - hair removed for surgery Postoperative care - neuro checks important (do together at bedside with previous shift RN), Do not turn pt to operated side! Brain tissue will shift toward opening on operated side Support patient and family Promote return to optimum functioning - go back to normal life as much as possible - wig/hat Neuroblastoma : Neuroblastoma is a cancer that develops from immature nerve cells found in several areas of the body. Neuroblastoma most commonly arises in and around the adrenal glands, which have similar origins to nerve cells and sit atop the kidneys Most common malignant extracranial solid tumor of childhood Majority develop in adrenal gland or retroperitoneal sympathetic chain Primary site within the abdomen Other sites: head, neck, chest, pelvis A “silent” tumor most found before age 5 extracranial - not in brain
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