Maintain contact after discharge and between remissions to encourage
follow-up care and respond to questions or provide emotional support.
Provide antiemetic and appetite stimulant to increase nutritional intake.
Offer foods after antiemetic takes effect to reduce nausea and maximize
caloric intake.
Allow to eat any food that is tolerated; avoid forcing food during nau-
sea episode.
Rinse mouth to remove unpleasant taste sensation.Lymphomas
What Went Wrong?
Lymphomas are lymph or reticuloendothelial system malignancies; they
account for about 15% of all malignancies. Lymphomas are categorized as
Hodgkin (most common in adults) or non-Hodgkin (most frequently occurring
in childhood). They both occur more frequently in boys than in girls and most
frequently in adolescents (Hodgkin, ages 15 to 19 years; non-Hodgkin <15
years of age). Metastasis occurs through lymphatic channels and spreads late
in the disease, to the lung, liver, and bone marrow.Signs and Symptoms
Common assessment findings:- History: May report anorexia, malaise, night sweats, and loss of weight.
- Cold that does not resolve completely.
- Pallor, fatigue, listlessness, irritability, and anorexia; fever may be noted.
- May mimic symptoms of rheumatoid arthritis symptoms or
mononucleosis. - Physical can reveal a painless, enlarged, rubbery-feeling lymph node
(cervical).
Test Results
Sedimentation rate elevated.
RBCs decreased.
Lymph node biopsy confirms diagnosis: Reed-Sternberg cells (large
multinucleated cells—nonfunctioning monocyte-macrophage cells).
Lymphangiogram for visualization of the lymphatic system with dye to
mark disease (dye can stain skin for up to 12 months).
Chest radiograph (large mediastinal nodes), CT scan (enlarged abdom-
inal lymph nodes ), and bone scans to stage the disease.Staging
Four subcategories: Lymphocyte predominant, nodular sclerosing (most
common in children), mixed cellularity, and lymphocyte depletion.2(^158) Pediatric Nursing Demystified