Learning Guide
Nursing Care of the Pediatric Individual with a Hematologic Disorder or
Cancer
Chapter 47
Iron deficiency anemia:
1. What is the cause of iron-deficiency anemia?
2. What diagnostic tests confirm iron-deficiency anemia?
3. Discuss the two main treatments:
a. Oral iron supplements – know side effects, how to give, etc.
b. Dietary teaching
Sickle Cell Diseases:
4. What is sickle cell disease? What is sickle cell anemia?
5. What are precipitating/ risk factors that will cause red blood cells to begin severe
sickling? Explain.
6. There are three types of sickle cell crisis. Which type is more common?
7. What is the most common reason for admission to the hospital for a child with sickle cell
disease?
8. What organs experience complications as a result of chronic sickling crises? What causes
these complications?
9. What diagnostic tests/lab tests would the healthcare provider order to diagnose sickle
cell disease?
10. Can the newborn have a diagnosis of sickle cell disease? What is the rationale for this
answer?
11. Why are blood transfusions ordered for the client in sickle cell crisis?
12. What are potential complications of frequent blood transfusions and what are the
nursing interventions for these complications?
13. Develop a plan for insuring hydration in the child with sickle cell. Remember to
incorporate teaching for the child/family that includes explanations to emphasize the
importance of hydration.
14. When providing instruction for long-term care of the child with sickle cell, what
medications should the nurse include regarding potential for infection?
a. Antibiotic therapyb. Immunizations-
Hemophilia:
15. Explain the Pathophysiology of hemophilia including:
a. What is an X-linked recessive disorder?
b. What factor is missing or defective?
c. Who is the carrier and who is affected by the disorder?
16. When is hemophilia most commonly diagnosed?
17. The classic sign of hemophilia is bleeding anywhere from, or in the body. During the
nurses’ assessment, what manifestations are commonly seen in each body system?
18. What laboratory tests would the nurse anticipate when the client is suspected of having
hemophilia? What is the explanation for a normal PT and a prolonged PTT?
19. What is the most commonly used form of Factor VIII. How does the nurse prepare and
administer this medication?
20. What is the primary nursing goal for hemophiliac and what are specific nursing
interventions to achieve this goal?
21. What is the major cause of death of a child with hemophilia?
Chapter 48
Childhood Cancer:
22. What are the cardinal signs and symptoms of childhood cancer?
Leukemia:
23. What are signs and symptoms in a child that would alert a healthcare provider to
suspect a diagnosis of leukemia?
24. What results from a CBC would support a diagnosis of leukemia?
25. Where is the most common site for bone marrow aspiration in a child?
a. How does the nurse prepare the child/family for this procedure?
b. What are the nursing responsibilities for this procedure?
26. Chemotherapy is the most common treatment modality of leukemia. Explain the three
phases of chemotherapy treatment:
a.
b.
c.
27. What are nursing interventions for the child receiving chemotherapy?
28. What does intrathecal administration of medication mean? What are the nursing
Responsibilities with regards to this route of medication administration?
29. In addition to chemotherapy, cranial radiation is often ordered. What is the rationale for
this additional treatment?
30. What is the cause of tumor lysis syndrome? What are the signs and symptoms of this
complication? What nursing interventions apply to this situation?
31. What is the purpose of bone marrow and stem cell transplantation in a child with
leukemia.
32. What is a major side effect of a bone marrow transplant?
33. What teaching must the nurse include concerning safety for the child with leukemia
throughout treatment?
Other Cancers:
34. Compare the clinical manifestations of neuroblastoma, osteosarcoma, ewing sarcoma,
rhabdomyosarcoma, retinoblastoma?
35. What are appropriate nursing management, planning and teaching of the child with the
above cancers.
36. Why would the nurse not want to palpate the abdomen of a child diagnosed with
Wilm's tumor/Nephroblastoma?
37. Nephrectomy is used in the treatment of Wilm's tumor. What are priority nursing
interventions in the post-operative period?
Death and Dying:
38. Describe the child's concept of death according to age:
a. Infants and toddlers
b. Early childhood (2-7 years)
c. Middle childhood (8-12years)
d. Adolescent (12+)
39. What nursing interventions are appropriate in caring for the child and family undergoing
the death and grief process?