Page 921 - Saunders Comprehensive Review For NCLEX-RN

15. Listen to the child and family, and encourage them to
verbalize their feelings and express their concerns.
16. Introduce the family to other families of children with
cancer, as appropriate
17. Consult social services and chaplains as necessary.

Monitor a child receiving chemotherapy closely for signs of

infection. Infection is a major cause of death in the immunosuppressed
child.
II. Hodgkin’s Disease
A. Description
1. Hodgkin’s disease (a type of lymphoma) is a
malignancy of the lymph nodes that originates in a
single lymph node or a single chain of nodes (Fig. 31-
1).
2. The disease predictably metastasizes to non-nodal or
extralymphatic sites, especially the spleen, liver, bone
marrow, lungs, and mediastinum.

3. Hodgkin’s disease is characterized by the

presence of Reed-Sternberg cells noted in a lymph
node biopsy specimen.
4. Peak incidence is in mid-adolescence.
5. Possible causes include viral infections and previous
exposure to alkylating chemical agents.
6. The prognosis is excellent, with long-term survival
rates depending on the stage of the disease.
7. The primary treatment modalities are radiation and
chemotherapy; each may be used alone or in
combination, depending on the clinical stage of the
disease.

B. Assessment

1. Painless enlargement of lymph nodes
2. Enlarged, firm, nontender, movable nodes in the
supraclavicular area; in children, the “sentinel” node
located near the left clavicle may be the first enlarged
node
3. Nonproductive cough as a result of mediastinal
lymphadenopathy
4. Abdominal pain as a result of enlarged retroperitoneal
nodes
5. Advanced lymph node and extralymphatic
involvement that may cause systemic symptoms, such
as a low-grade or intermittent fever, anorexia, nausea,
weight loss, night sweats, and pruritus

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