Pediatric Nursing Exam 1

Highly vascularized organs: liver, spleen, lymph, bone marrow

Profound anemia infection with left shift (increase in immature neutrophils) bleeding (petechiae anywhere that clothing tight)

Unrestricted proliferation of immature WBCs that act like a "circulating tumor" and can send out "fingers" into different organ systems and then compete for metabolic elements causing destruction to tissue around it.

Leukocytosis (increased WBC count >10,000) with very low percentage of mature WBCs

Hepatosplenomegaly and fibrosis

Leukemia Invading leukemic cells into bone marrow causes weakening

4-6 weeks corticosteroids, vincristine, L-aspariginase and maybe doxorubicin goal: remission or decrease cells to 5%

Doxorubicin daunomycin

Chemotherapy steroids hematopoietic stem cell transplantation (bone marrow transplant)

1)Induction therapy lasts 4-6 wks. Goal is to put into remission or decrease cells to 5% 2)Intesification therapy: after remission, Tx is intensified to eradicate remaining leukemic cells 3)Maintenance: daily and weekly IV,IM, and intrathecal meds for 2 yrs 4)Possible CNS prophylactic therapy 5)Possible relapse induction

Stop bone marrow from producing WBCs counteract inflammation from chemo

CNS prophylactic therapy: intrathecal methotraxate and cytarabine *injected into spinal column so X's blood-brain barrier for pts who have plaques in CSF or brain *it can kill Pts, so needs lots of checks

If the parent cannot handle being in the room, a play therapist or someone the child trusts must be there to help/hold hand/distract child

*Normal or low initial WBC count *Onset at 2-9 yrs rather than before 2 or after 10 *female *DNA index >1.16 and translocation of chromosomes 4 and 10

Antimetabolites that affect fast proliferating cells such as hair, nail, GI, bone marrow cells