Pediatric Nursing Demystified

Monitor for signs of septic shock.

Monitor for complications of cancer treatment:

Nursing alert It is critical to monitor for signs of complications and report

immediately so that the drug may be discontinued or reduced.

• Fever.


• Bleeding: Administer platelets, move body parts gently, avoid
  punctures.


• Anemia: Regular, not strenuous, supervised activity with rest periods.


• Nausea and vomiting: Administer antiemetic and appetite stimulant.

Nursing alertChildren may develop a hatred of foods offered during periods

of nausea so avoid offering favorite foods during chemotherapy administration.

Mucosal ulceration can occur with chemotherapy. Offer bland soft diet,

clean mouth with soft applicator, rinse mouth with salt water, and pro-

vide local anesthetics to relieve oral pain.

Hemorrhagic cystitis: Fluid intake, frequent voiding, early-day drug

administration, and drug to inhibit the condition.

 Neurologic problems may result from the neurotoxic effects of

chemotherapy. Nursing care addresses:

• Constipation: Physical activity, provide stool softeners and laxatives.


• Foot drop, extremity weakness or numbness: Apply footboard,
  inform parents and teachers so expectations of physical ability can
  be adjusted.


• Alopecia: Patchy baldness may be noted; hair returns in 3 to
  6 months.
  Prepare for head cover or wig prior to onset of alopecia to maintain
  self-esteem.
  Reduce shock of hair loss with advance notice and suggest loose
  cap to collect hair that falls out during the night.
  Steroid effects: Alert child and family of possible body changes such as
  moon face, mood changes.
  Watch for oncologic emergencies. Report and initiate treatments as
  ordered:


• Acute tumor lysis syndrome.


• Hyperleukocytosis.


• Overwhelming infection.


• Obstruction (compression of mediastinal structures could result in
  vena cava syndrome—monitor for and treat respiratory distress.

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