Pediatric Nursing Demystified

Increase foods high in iron.

Increase fluids if the patient has a fever to prevent dehydration.

Encourage self-care and normal independent activities of daily life.

No restrictions on daily activity.

Teach the parent:

• To give the patient a warm bath when awaking to reduce stiffness


• To avoid the patient remaining in a fixed flexion position


• That the patient should sleep 8 to 10 hours at a time to avoid fatigue.
  Avoid naps because this inactivity results in stiffness.


• That the patient should alternate between active and quiet activities
  to avoid fatigue.

Ewing Sarcoma

What Went Wrong?

Ewing sarcoma is cancer of the bone that stems from primitive nerve cells

and is related to chromosomal abnormalities. Ewing sarcoma metastasizes to

bone marrow, other bones, and the lungs.

Nursing alert Ewing sarcoma is commonly misdiagnosed as a sports injury.

Signs and Symptoms

Awakening at night with pain at the site of the tumor

Weight loss

Swelling at the site

A limp, if the legs are affected

Difficulty breathing, if ribs are affected

Test Results

Radiograph: Tumor present

CT scan: Tumor present

Bone marrow biopsy

Positive serology study for Ewing sarcoma cells

Treatment

Surgical removal of the tumor without amputation

Chemotherapy to kill the Ewing sarcoma cells

Nursing Interventions

Enable the child to make choices about daily care to give the child a

sense of control.

Teach the parents and the child about the disorder and treatment.

Encourage the child to continue normal activities of daily living as pos-

sible, including interaction with the child’s friends.

(^294) Pediatric Nursing Demystified