Care pain management pharmacological manage ivf

Care: pain management, pharmacological manage, IVF, nutriton, psychological, child life
Leukemia : most common peds malignancy, cancer of blood forming tissue

Acute Lymphocytic Leukemia ALL : most common leukemia, boys, survival rate 90%, peak age of onset 2-5
yrs, more common in caucasian
TX: Induction= wipe out blasts, 4-5 wks, corticosteroids to maintain high levels, chemo, family support, achieves
complete remission
Consolidation= chemo combination, several mo, eradicates residual leukemia cells, prevents further cloning
Maintenance= 2-5 yrs, chemotherapy, maintains remission phase
Relapse= can mutate, re-induction, start cycle again, use corticosteroid and chemo
Acute Myelogenous Leukemia AML: 15-20%, all leukemias, no associated age range or ethnicity, survival rate
65%, worse prognosis than ALL
Patho : unrestricted proliferation of immature WBC, not a tumor, infiltration and replacement of tissue in the body
with nonfunctional leukemic cells, competes for metabolic elements, destruction of cells, spleen, liver, highly
vascular organs
S&S: petechiae, infection, fatigue, fever, lymphadenopathy, hepatosplenomegaly
DX: CBC, pancytopenia, BM aspiration, LP
Prognosis: age onset 2-10, intial hgb level <10, low WBC, lack of B or T cell antigens, female
Hodgkins Lymphoma: disorder of lymphoid system, adolescent, 5 yr survival rate 85-90%, generally doesn’t metastasize
S&S: firm, nontender lymphadenopathy, enlarged, moveable nodes, supraclavicular or cervical area, fever, night sweats,
anorexia, wt loss
DX: lymph node biopsy, reed Sternberg cells, cxray, CT, MRI, CBC
TX: radiation or chemo
Non Hodgkins Lymphoma: more common, adolescence & young adults, males, malignant tumors of lymphoretical
network, lymphoblastic lymphoma, small non cleaved cell (Burkitts) lymphoma, mature B cells, non burkitt, large cell
lymphoma, aggressive or slow growing, B or T cell
S&S: painless, swollen lymph nodes, fever, fatigue, wt loss
DX: tissue biopsy, burkitts lymphoma may be preceded by Epstein barr virus
TX: chemotherapy tailored to stage of disease, removal of tissue mass
CNS tumor : 25% of childhood ca, most common, increased ICP & head circumference, difficult to treat, low survival
rate
DX: MRI, CT, LP (intracranial pressure- sudden relief), tissue biopsy
TX: surgery, radiation (not in kids less than 3- brain development), chemo
Neuroblastoma : extracranial solid tumor in infants, common in infancy, median age 22 mo, spontaneous regression, poor
prognosis, silent tumor
Wilms Tumor: malignant, rises from kidneys, peak at 2-4 yrs, Males> Females, painless swelling or mass in abdomen,
DON’T PALPATE, rapid growing, double in size in 11-13 days, hemorrhage in hours
DX: CT, ultrasound, MRI, chest CT, CBC, kidney function, UA
TX: 90% cure rate, surgery, chemo, radiation
Osteogenic Sarcoma : most common bone cancer, tumors in long bones
TX: surgery, chemo, amputate limb, limb salvage, 75% for non metastatic pts
Ewings Sarcoma : cancer of marrow in bone,
TX: chemo, radiation, no amputation needed, 79% survival 4 yrs if no metastasis
Rhabdomyosarcoma : cancer of striated skeletal muscle, <6 yrs, males
S&S: similar to child illness