Reduce risk for injury, decreased skin integrity, related to radiotherapy.
Position leg gently to avoid disruption of neurologic or circulatory
function.
Dress child in loose-fitting clothing over treated site to reduce pressure
and pain at site.
Protect affected skin area from direct sunlight and temperature extremes
from heat pads or ice packs.
Elevate limb to reduce swelling.
Encourage activity and use of extremity as tolerated when therapy is
complete.
Assess client for adequate nutritional intake:- No weight loss
- Lab work reveals protein levels within normal range
Provide antiemetic and appetite stimulant.
Offer foods after antiemetic takes effect to minimize nausea and increase
intake.
Allow to eat any food that is tolerated; avoid forcing food during nau-
sea episode.
Rinse mouth to remove unpleasant taste sensation.
What Went Wrong?
Other Solid Tumors: Nephroblastoma(Wilms tumor), a malignant tumor
composed of metanephric mesoderm cells of the upper pole of the kidney,
accounts for 20% of the solid tumors found in children. Most cases (approxi-
mately 80%) are discovered in children <5 years of age with most cases occur-
ring between the ages of 3 and 4 years. Increased incidence is seen among
siblings, and Wilms tumor is associated with several congenital anomalies,
most commonly including hemangioma, aniridia (lack of color in the iris),
cryptorchidism, hypospadias, pseudohermaphroditism, cystic kidneys, and
talipes disorders. The tumor is primarily located in the intraabdominal and
kidney area. The metastatic spread is most often to the lungs, regional lymph
nodes, liver, bone, and eventually spreads to the brain by the bloodstream.Signs and Symptoms
Presents most commonly as firm, nontender, mass deep within the flank
and confined to one side of the body (may be confused with liver on pal-
pation but does not move with respiration).
Other symptoms may result from organ compression from tumor, meta-
bolic alterations from the tumor, or metastasis.
Hematuria may be noted in less than half of cases.
Tumor may seem to appear suddenly if it hemorrhages into itself dou-
bling in size in a short time.
Anemia with accompanying pallor, anorexia, and lethargy may be noted.CHAPTER 8/ Oncology Conditions^163