Pediatric Nursing Demystified

Understanding the processes of abnormal cell growth will help the nurse

explain to parents what is happening to their child and why certain treatment

measures are needed at various stages of cell growth. These are the key

points:

New cells do not respond to normal communication instructing cells to

stop growing when touching another cell; thus overgrowth occurs.

 Theories on what went wrong—childhood neoplasm development:

• Gene theory, familial predisposition for cell mutation.


• In utero exposure to carcinogen.


• Exposure to carcinogen such as secondary smoke or asbestos.


• Previous cancer produces high risk for additional cancer.


• Oncogenic virustheory: A virus such as Epstein-Barr causes cancer.


• Tumor suppressor cell deficit: Lack of suppression results in over-
  growth, such as with retinoblastoma

Signs and Symptoms

Client History

Present illness: Active disease or in remission state

Previous illness: Immunization history, surgeries, previous cancer events

Developmental stage: Milestones achieved

Family Assessment

Family history of cancer: Note type, treatment, and outcome; note pedi-

atric cancers.

Family type and concerns related to child’s condition and treatment.

Presence of other family crises—family member illness, divorce, finan-

cial burdens—could decrease emotional and financial support for the

child with cancer.

Stress from the cancer diagnosis and subsequent long-term treatment of

the child with cancer can destabilize a family and exacerbate existing

problems.

Sibling responses to the cancer diagnosis can range from fear for self to

grief and fear about loss of a sibling.

Symptoms

Vague symptoms such as headache, fatigue, or general skeletal aches

may be reported.

May report nosebleeds (low platelet count).

Weight loss in an apparently healthy child, particularly cachexia(weight

loss along with muscle loss and poor appetite), is a common symptom

of cancer.

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