Problem
I. A 16-year-old patient presents to the behavioral health clinic with inability to concentrate and hyperactivity. The patient's mother would like him assessed for attention- deficit hyperactivity disorder. While speaking with the patient, the healthcare provider notes a large goiter.
i. What endocrine disorder could be causing this patient's symptoms?
ii. What other symptoms would the healthcare provider expect to assess?
iii. What treatment would the healthcare provider likely implement?
II. Mark Thompson is a 16-year-old patient who was admitted yesterday to the pediatric oncology unit for newly-diagnosed Hodgkin lymphoma. Further testing revealed that Mark has involvement of lymph nodes on both sides of his diaphragm and in his spleen. He is scheduled to begin chemotherapy this evening. Mark states, "I can't believe this is happening. It feels like my whole life changed overnight. I hate not knowing what will happen."
i. What stage lymphoma does Mark have? What clinical manifestations would you expect to see in your assessment?
ii. What are some oncological emergencies that can occur during chemotherapy treatments?
iii. What impact does a cancer diagnosis have on the psychosocial status of the patient and their family? What referrals can the nurse make to minimize this impact?
III. A 15-year-old child is admitted to the pediatric oncology unit for newly-diagnosed osteosarcoma. The child will undergo chemotherapy and then surgical resection.
i. What types of surgical interventions are used for osteosarcoma?
ii. What impact does amputation have on the psychosocial development of an adolescent?
iii. What actions can the nurse take to lessen this impact on the child's development?
IV. A 3-year-old child presents to the healthcare clinic with abdominal swelling, flank pain, hematuria, fever, andhypertension. The nurse suspects that the child may have Wilms tumor.
i. What assessment techniques should be avoided in this patient? Why should they be avoided?
ii. What is the pathophysiology behind Wilms tumor?
V. A 2-year-old child presents to the pediatric oncology clinic with newly diagnosed retinoblastoma. The caregivers are visibly upset and the mother states, "How could I not notice that my baby had a tumor? I can't believe I didn't notice any changes. What is the plan now? How do we treat this?"
i. What are the clinical manifestations of retinoblastoma?
ii. What are the usual treatments for retinoblastoma?