Nursing 211

N211: Health Differences Across the Lifespan I

3.25 Bone Tumors Bone Tumors are tumors that arise from a bone cell, probably an osteoblast. The most common bone cancer is in children. Osteogenic sarcoma usually occurs in adolescent boys; tumor growth is detected at a time of rapid bone growth. Benign bone tumors are more common than malignant tumors. Primary malignant tumors of the musculoskeletal system are rare and originate in the connective and supportive tissue (sarcoma) or bone marrow elements (myelomas). Osteosarcoma is the most common and most often fatal primary malignant bone tumor. The patient presents with pain, swelling, limitation of movement, and weight loss. The mass be palpable, tender and fixed with an elevation of skin temperature over the mass. Chondrosarcoma is a malignant tumor of the hyaline cartilage, and the second most common primary malignant bone tumor. They are large, bulky, slow growing tumors that affect adult males most often. Most often they do not metastasize. Amputation of the affected extremity results in increased survival rate. Nursing Assessment Reveals pain and swelling as initial symptoms. Follow up tests include CT or MRI imaging to detect areas of metastasis. Nursing Diagnosis • Altered comfort; pain related pathologic processes and surgery • Ineffective management of therapeutic regimen related to lack of knowledge of disease process, complications, and required treatments • High risk for injury related to pathologic fracture secondary to tumor • Disturbance in self-esteem related to loss of body part or alteration in role performance. Medical Intervention May include radical resection or amputation. Selected clients have limb salvaging procedures with prosthesis replacement. Nursing Interventions Include providing comfort and pain; management; sterile residual limb care; elevate residual limb for 24 hours; maintain body alignment; perform ROM to joints proximal to the amputation. Provide opioid analgesics to relieve pain. Assist with early ambulation, assist with temporary prosthesis. 3.26 Sarcoma Sarcoma is a tumor of the bone that is extremely malignant. There are three types: osteogenic sarcoma, osteoclastoma and Ewing’s sarcoma. Osteosarcoma is the most common bone malignancy


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