Nursing 211

N211: Health Differences Across the Lifespan I

Nursing Diagnosis • Anxiety and knowledge deficit of child and parents related to diagnosis of cancer and treatments • Risk for fluid volume deficit related to fluid loss during surgery • Pain related to muscle manipulation and tissue trauma secondary to surgery and possible progression of the disease • Altered nutrition: less than body requirements related to anorexia and nausea secondary to side effects of treatment • Risk for infection related to myelosuppression from chemotherapy and radiation therapy • Body image disturbance related to surgery and side effects of chemotherapy • Activity intolerance related to effects of radiation therapy, surgery, or chemotherapy. Medical Interventions Include surgery to remove affected kidney and check for metastasis. Radiation to abdomen and chemotherapy can be used before and/or after surgery. Nursing interve tions Include measuring I&O, monitor daily weight and urine specific gravity, monitor fluid levels, IV infusions and blood pressure. Monitor vital signs and provide pain relief with medications. Monitor bowel sound, abdominal distention and bowel movements. Monitor for infection, observing surgical wound and body temperature. Maintain nasogastric tube and support child and family during chemotherapy and radiation therapy. 3.22 Brain Tumors Brain tumors are the second most common cancer in children. Most brain tumors are infratentorial, making them difficult to excise surgically. Tumors usually occur close to vital structures. Gliomas are the most common childhood tumor. Most adult brain tumors are supratentorial. Benign brain tumors can also be fatal because of the solid skull which allows no room for expansion of tumor and thus causing increased intracranial pressure. The cause is unknown, although radiation and environmental factors may play a role. Gliomas arise from the brain tissue and usually cannot be removed because they spread by infiltration unto surrounding tissues.

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