Pediatric Cancer

CASE STUDIES
I- Case Study: Care of the Child in Inpatient and Outpatient Settings
Jordan is 9-year-old male who is a direct admit for observation. He has a history of vomiting and diarrhea for 48 hours.
Subjective Data
· Nausea and vomiting for 24 hours
· Has not voided today
· Unable to tolerate oral fluids
Objective Data
· Vital signs: T 37.8° C, P 120, R24, BP 110/60
· Weight: 34 kg
· Hyperactive bowel sounds to auscultation

Question 1

When should the discharge teaching begin for Jordan and his family?

Question 2

What is the best way to approach Jordan regarding the IV that has been ordered.

Question 3

What would be good distractions for a child of Jordan’s age?

II- Case Study: Pediatric Cancer

Mario is a 7-year-old male who presents with a 1-week history of body aches and pallor. He has a 2-day history of fever to 103° F and a 1-day history of bruising and lethargy.
Subjective Data
· Complains of hurting all over
· States he feels very tired
· States he feels dizzy when he stands up
Objective Data
· Weight 26.1 kg
· Vital signs: T 38.9° C, P 140, R 40, BP 108/54, O2 sat 100%
· Purpural rash on extremities
· WBC 0.7
· HGB 3.1
· Hct 8.5
· Plt .08
· ANC 0.1

Question 1

Which of Mario’s presenting symptoms must be treated and stabilized before chemotherapy induction?

Question 2

What testing is required for a definitive diagnosis of meningitis?

Question 3

What should the nurse do in this clinical situation? Prioritize actions.