Cancer is the #1 disease-related cause of death in infants, children, and adolescents.
What cooperative group coordinates pediatric cancer treatment plans?
Children's Oncology Group
Children's Hospital of Philadelphia
American Pediatric Cancer Association
Mayo Clinic
What facts about acute lymphoblastic leukemia can you give to the parents of a child diagnosed with it?
"This cancer is the most common cancer of children; it accounts for 3/4 of childhood leukemia cases."
"All pediatric age groups have the same amount of risk for getting leukemia."
"The five-year survival rate for a standard-risk child is 90%."
"The five-year survival rate for a standard-risk child 64%."
"It is more common in children with chromosomal disorders."
You have delivered teaching to the parents of a child with acute myelogenous leukemia.
Which of the following statements shows that more teaching is needed?
"This type of leukemia is not as common; it represents 17% of all childhood leukemia."
"It has a higher rate in the first 2 years of life."
"It has a 5-year survival rate of 64%."
"It has a sharp peak in ages 2-3 years."
What are the known risk factors for acute myelogenous leukemia?
Ionizing radiation in utereo
Constitutional genetic disorders, such as trisomy 21
Prenatal environmental factors, such solvents and pesticides.
Accelerated fetal growth
Low birth weight
Which of the following is accelerated fetal growth/high birth weight not associated with?
Acute lymphoid leukemia
CNS tumors
Wilms tumor (kidney tumor)
Non-Hodgkins lymphoma
Embryonal rhabdomyosarcoma
Acute myeloid leukemia
Parents with a child newly diagnosed with leukemia asks you what treatment may consist of.
Which of the following shows the BEST teaching?
"You have a few options: chemo, surgery, radiation, biotherapy, and a stem cell transplant. Your oncologist will discuss with you what option, or combination of options, is best."
"There is not a great deal of options available, aside from chemtotherapy and radiation."
"Ask your oncologist what your child's treatment consists of."
"For leukemia, your only option is likely stem cell transplantation."
Which of the following is UNTRUE about neuroblastomas?
They're usually stage IV when diagnosed.
The 5-year survival rate is 79%.
It arises from the adrenal gland or sympathetic ganglia.
Most of these types of tumors secrete catecholamines.
Which of the following is NOT a symptom of a neuroblastoma?
Lump in the abdomen
Lump in the chest
Bone pain
Bruising around the eyes
Petechiae
Which of the following is not true about Wilm's Tumor?
It's a rare kidney cancer that primarily affects children.
1-2% is familial and associated with a gene on chromosome 11.
It's most common between age 3-4
Overall 5-year survival rate is at 90%
The best way to assess for the tumor is palpation.
What stage of the grieving process is this patient in?
"I still don't understand how my child could have cancer."
Denial
Anger
Bargaining
Depression
Acceptance
"I am so pissed at myself for getting an X-ray while I was pregnant. Why did I have to break my arm?"
Bargianing
"I promised God that if he brought my son through this, I would dedicate my entire life to praising him."
"I don't think I can live the rest of my life without my baby."
"My son is with the Lord now."
Which of the following does not influence a child's ability to cope with loss?
The caregiver's ability to communicate and provide emotional support.
Support from peers and others.
Prior experience with loss.
Religious and cultural belief system.
Socioeconomic level.
What would you expect to see and hear when performing a physical assessment of a dying child?
Cool, clammy skin
Skin is cyanotic and mottling
Death rattle
Moaning/grunting with breathing
Shivering
Dyspnea.
What findings would you expect to see when performing a neurological assessment on a child that is dying?
Agitation or restlessness
Deterioration of hearing and vision
Decreasing level of consciousness, ending in loss of consciousness.
Brief burst of energy right before death.
Auditory and/or visual hallucinations
What musculoskeletal, urinary, and bowel findings would you expect to find when assessing a child who is dying?
Extreme weakness
Inability to speak or swallow, leading to decreased fluid intake and/or anorexia
Decreased urine output
Bladder/bowel incontinence
Hypotonia or hypertonia
Twitching of fingers and/or toes
Which of the following vital sign findings would you expect to see in a child that is dying?
Tachypnea
Bradypnea
Tachycardia
Hypotension
