Introduction
Pediatric oncology nursing focuses on providing specialized
care for children diagnosed with cancer. This role encompasses clinical
expertise, emotional support, and advocacy to ensure the best outcomes for
young patients and their families. Pediatric cancers often differ from adult
cancers in type, treatment, and impact, necessitating a unique and
compassionate approach.
Common Pediatric Cancers
- Leukemia
- Overview:
Leukemia is the most common pediatric cancer, accounting for
approximately 30% of childhood cancers. It primarily involves the
abnormal proliferation of white blood cells.
- Types:
- Acute
Lymphoblastic Leukemia (ALL) – most common.
- Acute
Myeloid Leukemia (AML).
- Symptoms:
Fatigue, pallor, frequent infections, bruising, bone pain, and
hepatosplenomegaly.
- Treatment:
Chemotherapy, bone marrow transplant, and supportive therapies.
- Neuroblastoma
- Overview:
A solid tumor originating from neural crest cells, typically found in the
adrenal glands or along the sympathetic nervous system.
- Epidemiology:
Common in children under five years.
- Symptoms:
Abdominal pain, mass, weight loss, bone pain, and periorbital bruising.
- Treatment:
Surgery, chemotherapy, radiation, and immunotherapy.
Nursing Care During Chemotherapy and Radiation
- Chemotherapy
- Administering
Chemotherapy: Ensure correct dosages and protocols, verify IV access,
and monitor for extravasation.
- Managing
Side Effects:
- Nausea
and Vomiting: Administer antiemetics as prescribed (e.g., ondansetron).
- Bone
Marrow Suppression: Monitor for anemia, neutropenia, and
thrombocytopenia. Educate caregivers on infection prevention strategies.
- Mucositis:
Promote oral hygiene using non-irritating solutions; recommend a soft diet.
- Hair
Loss: Prepare the child and family emotionally, and discuss options like
wigs or head coverings.
- Radiation
Therapy
- Preparation:
Educate the child and family about the procedure to reduce fear and
anxiety.
- During
Treatment:
- Ensure
accurate positioning to target the tumor effectively.
- Protect
unaffected areas of the body from radiation exposure.
- Post-Treatment
Care:
- Monitor
for radiation burns and provide appropriate skin care (use gentle,
non-irritating products).
- Address
fatigue and encourage rest.
Psychosocial Support for the Child and Family
- Child-Centered
Support
- Use
age-appropriate communication to explain the diagnosis and treatment.
- Incorporate
play therapy and art therapy to help the child express feelings and
reduce stress.
- Support
peer interactions to minimize feelings of isolation.
- Family
Support
- Provide
honest and empathetic communication about the child’s condition and
prognosis.
- Offer
guidance on balancing medical care with maintaining normalcy in daily
life.
- Connect
families with support groups and counseling services to manage emotional
and financial challenges.
- Siblings'
Involvement
- Educate
siblings about the illness to reduce misconceptions and fear.
- Encourage
family activities to maintain bonds.
Palliative Care in Terminal Cases
- Recognizing
the Need for Palliative Care
- Transition
to palliative care when curative treatments are no longer effective.
- Focus
shifts to enhancing quality of life and comfort.
- Pain
and Symptom Management
- Use
pharmacological methods (e.g., opioids, sedatives) and
non-pharmacological techniques (e.g., massage, relaxation).
- Monitor
and manage symptoms such as breathlessness, fatigue, and gastrointestinal
discomfort.
- Psychosocial
and Emotional Support
- Address
emotional distress, including fear and sadness, for the child and family.
- Provide
spiritual support based on the family’s beliefs.
- End-of-Life
Care
- Ensure
dignity and comfort during the dying process.
- Support
the family through grief, offering bereavement counseling and memorial
planning assistance.
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