N211: Health Differences Across the Lifespan I in children. Osteoclastoma is a destructive tumor of the long bones in young adults. Most of these giant cell tumors are begin. Clinical manifestations include swelling, local pain, and some disturbance in joint function. Recurrent tumors may result in amputation. Ewing’s sarcoma is characterized by rapid growth within the medullary cavity of the long bones, especially the femur, pelvis, tibia, humerus and ribs. It metastasizes frequently to the lungs. Nursing Assessment Includes pain at the affected site and a limp; palpable, fixed, and tender bony mass. Other symptoms include fatigue, anorexia, weight loss, and anemia. Diagnostics Include CBC with differential, blood chemistries, X-ray of lesion, CT scan, MRI, radionuclide bone scan and biopsy of the lesion. Nursing Diagnosis • Anxiety and knowledge deficit of parents and child related to diagnosis of cancer and treatments • Pain related to surgery and possible progression of the disease • Altered nutrition: less than body requirements related to side effects of chemotherapy • Risk for infection related to myelosuppression from chemotherapy • Body image disturbance related to surgery and effects from chemotherapy • Activity intolerance related to fatigue secondary to the effects of surgery and chemotherapy Nursing Interventions Includes explaining and reinforcing information regarding diagnosis and treatments; allow parents and child to express their feelings; answer questions to correct misconceptions; allow parents to remain with child as much as possible and to participate in care. Maintain a calm and relaxed environment. Provide appropriate diversional activities. Assess pain using pain scale of 0-10. Administer analgesics as ordered. Provide small, frequent meals. Monitor CBC and differential count monitor temperature and hydration. Protect patient form potentially infectious sources. Assess patient’s tolerance of activities, encourage to pace activities. Monitor hemoglobin and hematocrit and administer blood products as ordered. Encourage mobility of extremity as tolerated. Allow open communication with child and family about disease and prognosis. Lymphomas are a group of malignant neoplasms that affect the lymphatic system; resulting in proliferation of lymphocytes; it can be classified as Hodgkin’s lymphoma or non-Hodgkin’s lymphoma. Hodgkin’s disease is more common in men than in women. Etiology is unknown. It is characterized by the presence of Reed-Sternberg cells, a multinucleated and gigantic tumor cell thought to be of the lymphoid origin.
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