Page 925 - Saunders Comprehensive Review For NCLEX-RN

having recognized signs in the child earlier.
4. Refer parents to appropriate community services.
V. Osteosarcoma (Osteogenic Sarcoma)
A. Description

1. The most common bone cancer in children; it

is also known as osteogenic sarcoma.
2. Cancer usually is found in the metaphysis of long
bones, especially in the lower extremities, with most
tumors occurring in the femur.
3. The peak age of incidence is between 10 and 25 years.
4. Symptoms in the earliest stage are almost always
attributed to extremity injury or normal growing
pains.
5. Treatment may include surgical resection (limb
salvage procedure) to save a limb or remove affected
tissue, or amputation.
6. Chemotherapy is used to treat the cancer and may be
used before and after surgery.

B. Assessment

1. Localized pain at the affected site (may be severe or
dull) that may be attributed to trauma or the vague
complaint of “growing pains”; pain often is relieved
by a flexed position.
2. Palpable mass
3. Limping if weight-bearing limb is affected
4. Progressive limited range of motion and the child’s
curtailing of physical activity
5. Child may be unable to hold heavy objects because of
their weight and resultant pain in the affected
extremity.
6. Pathological fractures occur at the tumor site.

C. Interventions

1. Prepare the child and family for prescribed treatment
modalities, which may include surgical resection by
limb salvage to remove affected tissue, amputation,
and chemotherapy.
2. Communicate honestly with the child and family and
provide support.
3. Prepare for prosthetic fitting as necessary.
4. Assist the child in dealing with problems of self-
image.
5. Instruct the child and parents about the potential
development of phantom limb pain that may occur
after amputation, characterized by tingling, itching,

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