HPC IN PRESCHOOLER 1

• NURSING CARE OF A FAMILY WHEN A CHILD HAS A MALIGNANCY

  Leukemias

  Wilm’s Tumor (nephroblastoma)
• Malignant and cancerous - Describe cells that are growing and proliferating in a 8sorderly, chaotic fashion.
• In adults, cancer usually occurs in the form of a solid tumor
• In children, the most frequent type of cancer is that of immature white blood cell (WBC) overgrowth, or leukemia.
• HEALTH PROMOTION AND RISK MANAGEMENT

  • Reduce children’s exposure to secondary cigarette smoke and urging adolescents not to begin smoking
  • Applying sunscreen, reducing the overall time of sun exposure
  • Children who receive chemotherapy or radiation for one cancer have higher incidence of developing another cancer later in life
  • Both boys and girls should receive the vaccine against human papillomavirus (HPV)
  • Seek health maintenance care or evaluation for their other children
• NEOPLASIA - All body tissue undergoes continuing growth to develop and maintain that specific type of tissue
• Normally, the body is able to balance the proliferation necessary to replace old cells that die puls produce new cells for physical growth needs
• Cancerous, or malignant, tissue, however, is unable to maintain this balance and begins to proliferate in disorderly, chaotic ways.
• NEOPLASM means “new growth"
• NEOPLASIA -Typically used to refer to a new abnormal growth that does not respond to normal growth-control mechanisms.
• CELL GROWTH - Normal cells appear to be able to recognize and communicate with one another to stop growth when they touch or become crowded.
• Neoplastic cells - do not respond to this communication or cannot receive it, so, despite how crowded they are, they continue to grow.
• a tumor mass is detected by palpation
• 30 times the size of its original aberrant cell.
• Neoplasms

  • Benign (growth is limited)
  • Malignant (cancerous or with unlimited growth)
• Benign - completely harmless but It can cause damage by pressing on adjacent tissue.
• CAUSES OF NEOPLASTIC GROWTH - exact origin of neoplastic growth is unknown
• environmental exposures - chronic exposure to chemical irritants or cigarette smoke.
• Tumors of skin, bladder, lung, and intestines involve organs exposed to such outside influences and irritation. 
• In adults, tumors may grow because normal cell growth has been altered by environmental exposures.
• In children, Tumors most frequently occur in organs unexposed to the environment.
• unexposed to the environment

  • Leukemia or the bone marrow
  • Nephroblastoma of the kidney (Wilm tumor)
  • Brain tumor
  • Neuroblastoma in the abdomen
• Somatic mutation Theory - accumulation of mutations in the cell is what ultimately results in the transformation to a neoplastic state.
• Somatic mutation Theory - This theory explains why the growth of neoplastic is not reversible and why neoplasms occurs in some people but not in others.
• Oncogenic viruses - (cancer-causing virus) such as HPV may be directly responsible for tumor growth
• Examples of Oncogenic viruses

  C-type RNA viruses - have been implicated in leukemia
• Example of Oncogenic viruses

  Epstein-Barr virus (EBV) is associated with Burkitt lymphoma.
• Many cancers in children have been developing for some time before a child is brought for care because the symptoms:

  • Bruising
  • Nosebleeds
  • Headache
  • Pain in a knee
  • Constipation
• Cachexia (loss of weight, anorexia) occurs if the tumor is growing so rapidly that it takes nutrients from normal cells.
• • Thorough history taking at health care visits can help reveal these symptoms, so that a child can be further evaluated and a cancer discovered early in its growth.
• As malignant tumors grow, they tend to cause systemic effects in the child.
• General Signs and Symptoms of Cancer

  • Unexplained fever
  • Bleeding / bruising
  • Morning headaches and neurologic changes
  • Palpable abdominal mass
  • Swollen lymph nodes
  • Bone and joint pain
  • Fatigue
• Signs of Cancer (CAUTION US)

  • Change in bowel / bladder habits
  • A sore that doesn’t heal
  • Unusual bleeding / Discharge
  • Thickening of lump - breast or elsewhere
  • Indigestion / Dysphagia
  • Obvious change in wart / mole
  • Nagging cough / hoarseness
  • Unexplained anemia
  • Sudden weight loss
• General Symptoms of Malignancy

  1. Unexplained weight loss
  2. Fever
  3. Fatigue
  4. Pain
  5. Skin changes (itching, darkening reddening, hairiness)
• General Signs of Malignancy

  1. A change in bowel or bladder habits
  2. A non healing sore
  3. Unusual bleeding or discharge
  4. A thickening or lump in the breast or other body part
  5. Indigestion or difficulty swallowing
  6. An obvious change in a wart or mole
  7. A nagging cough or persistent hoarseness
• Several diagnostic procedures;

  • Radiography (X-ray)
  • Ultrasound
  • Magnetic resonance imaging (MRI)
  • Blood analysis
  • Biopsy
• BIOPSY - is the surgical removal of tissue cells for laboratory analysis.
• BIOPSY - Are classified as minor surgery and usually are done on an ambulatory basis.
• Bone marrow aspiration - is a frequent type of biopsy used with children.
• Bone marrow aspiration - Done with only local anesthesia