Vincristine
Cisplatin
Actinomycin D
Cyclophosphamide
VP-16
Doxorubicin
Ifosfamide
Etoposide- Three-year survival increased to 80% with vigorous treatment
Nursing Interventions
Address fear related to diagnostic tests, procedures, and treatments to
promote cooperation from the child and parents—responses to verbal
directives with minimal resistance.
Reinforce physician’s explanation of diagnosis and treatment plan.
Explain procedure at child’s level of understanding including what will
be seen, felt, heard, and smelled.Nursing alert Instruct the child not to put weight on the affected limb due to
danger of a pathologic fracture.Explain what child is expected to do during test and care activities.
Use distraction techniques to reduce focus on procedure and fear:- Involve client in procedure if possible—holding tape, repeat steps.
Position leg gently to avoid disruption of neurologic or circulatory
function.
Address potential injury related to surgery and bone prosthesis: - Elevate limb to reduce swelling.
Assess neurologic and circulatory system for absence of disruption: - Dry or moist desquamation followed by hyperpigmentation
expected. - Minimal skin irritation and absence of ulceration.
- Extremity distal to incision warm to touch.
- Capillary refill <5 seconds.
- No report of tingling or numbness in distal extremity.
Nursing alert Instruct adolescents to avoid excessive stress on leg that has
received extensive radiation (no football, no weight lifting with pressure on
that leg) because leg may not be as strong as normal afterward.Assess pain level on a pain scale prior to and after treatment.
Administer analgesic to control pain.4(^162) Pediatric Nursing Demystified