Hematologic cancer- children

A four-year-old child diagnosed with leukemia presents with a headache, nausea and vomiting, and slight confusion. Which action should the nurse take?

Secure consent for lumbar puncture.

The nurse is assessing a child whose parents report malaise, abdominal pain, knee, and leg pain. The nurse notes significant hepatosplenomegaly. Which other objective findings would indicate a possible leukemia diagnosis?

Elevated WBCDecreased platelet countmasses in groin & axillae

A three-year-old child presents to the ER after a sudden onset of nosebleed, small red spots on the skin, stomachache, and poor appetite. Which evaluation should the nurse prepare this child?


A two-year-old child presents with fever, night sweats, splenomegaly, and blood studies indicating presence of Reed-Sternberg cells. Which action is a priority for the nurse to take?

Prepare child for bone marrow aspiration.

The nurse is assessing a female child diagnosed with Hodgkin lymphoma. When taking a patient history, which information from the patient's parents would the nurse expect?

She has had a lot of unexplained fevers lately.""She just doesn't have much energy for play anymore."She has a poor appetite recently.

The parents of a seven-year-old child report swelling in the child's neck and recent fatigue. They are apprehensive about the diagnosis and ask the nurse about the progression of Hodgkin lymphoma. Which information should the nurse include in the response?

Hodgkin Lymphoma begins in the lymph nodes.

The nurse is caring for a child with potential non-Hodgkin Lymphoma (NHL). Which medical history information could increase the child's risk for developing the disease?


The nurse is caring for a child with Non-Hodgkin's Lymphoma who presents in a tripod position, is diaphoretic, and has shortness of breath. The nurse notes a left-sided tracheal deviation, diminished lung sounds on the right side, and SpO2 of 84 percent. Which action is most important for the nurse to take?

Prepare for intubation

The nurse is assessing a child with non-Hodgkin's Lymphoma and notes elevated serum sodium, serum potassium, BUN, and uric acid levels. The child reports urinating only once in the past two days. Which action is most important for the nurse to take?

Initiate IV fluid resuscitation.

A four-year-old child comes to the Emergency Department with his mother, who states that the child is just not feeling himself. The child has been irritable and often seems out of breath. A urinalysis shows evidence of uric acid crystals. Which action should the nurse do first?

Prepare child for a chest x-ray

A six-year-old child with leukemia presents with altered level of consciousness (LOC) and sluggish pupils but no cardiac compromise after falling from a bike. The nurse notes a platelet count of 10,000, WBC of four, and hemoglobin of seven. After the patient's airway is stabilized, which priority order should the nurse anticipate?

Obtain a head CT

The nurse is caring for a four-year-old child with leukemia who is receiving chemotherapy. The parent reports that the child has abdominal pain, nausea, and vomiting. Upon exam, the nurse notes poor skin turgor, pallor, dry mucus membranes, and poor appetite. Which action should the nurse take first?

Administer normal saline IV bolus

A child diagnosed with leukemia reports nausea, vomiting, and anorexia related to chemotherapy treatment. The nurse notes a hemoglobin count of 10, WBC count of 8, platelet count of 103,000, and an albumin level of 2.1. Which prescription would the nurse anticipate?

Administer total parenteral nutrition

The nurse is educating the parents of a child with leukemia about necessary homecare. During the teaching session, the mother states, "We plan to let him return to baseball practice next week." Which information is most important for the nurse to include in the response?

Avoid physically exhausting activities.

A two-year-old child diagnosed with Hodgkin Lymphoma presents with enlarged neck lymph nodes, and an x-ray reveals widening of the mediastinum. Which action should the nurse take first?

Assess the child's airway for patency

The nurse is caring for a 16-year-old child diagnosed with Hodgkin Lymphoma who reports shortness of breath, and chest pain. The nurse notes hoarseness of patient's voice when speaking. Which prescription would the nurse take first?

Obtain an emergency chest radiograph

The nurse is caring for a 17-year-old with single-node Hodgkin lymphoma who reports right upper quadrant pain, nausea and vomiting. The nurse notes icteric skin and sclera, and abdominal distention. Which prescription would the nurse anticipate?

Obtain serum AST and ALT levels

The nurse conducts an assessment on a child who presents with swelling and discomfort in the axilla, persistent cough, and dyspnea. Which assessment is a priority?

Tracheal position

A child is admitted to the hospital with Non-Hodgkin lymphoma, and reports having lower abdominal pain of 6/10. The nurse notes a temperature of 102.3° F, heart rate 107 and respiratory rate 14. Which actions are most important for the nurse to take?

obtain blood & urine culture

The nurse is evaluating a child who was admitted for persistent cough, dyspnea, swelling, and discomfort in the neck and axilla. Lymph node biopsy confirmed that the child has Non-Hodgkin Lymphoma. Which question would best determine the effectiveness of nursing care to this patient?

Has the child's respiratory status remained stable?