A child has an absolute neutrophil count (ANC) of 500/mm3. The ...

[kellyjaisingh]

A child has an absolute neutrophil count (ANC) of 500/mm3. The nurse should expect to be administering which prescribed treatment?
 
  a. Platelets
  b. Packed red blood cells
  c. Zofran (ondansetron)
  d. G-CSF (Neupogen) daily

Question 2

One pediatric oncologic emergency is acute tumor lysis syndrome. Symptoms that this may be occurring include what?
 
  a. Muscle cramps and tetany
  b. Respiratory distress and cyanosis
  c. Thrombocytopenia and sepsis
  d. Upper extremity edema and neck vein distension

[HandsomeMarc]

Answer to Question 1

ANS: D
G-CSF (filgrastim Neupogen, pegfilgrastim Neulasta) directs granulocyte development and can decrease the duration of neutropenia following immunosuppressive therapy. G-CSF is discontinued when the ANC surpasses 10,000/mm3.

Answer to Question 2

ANS: A
Risk factors for development of tumor lysis syndrome include a high white blood cell count at diagnosis, large tumor burden, sensitivity to chemotherapy, and high proliferative rate. In addition to the described metabolic abnormalities, children may develop a spectrum of clinical symptoms, including flank pain, lethargy, nausea and vomiting, muscle cramps, pruritus, tetany, and seizures. Respiratory distress and cyanosis occur with hyperleukocytosis. Thrombocytopenia and sepsis occur with disseminated intravascular coagulation. Upper extremity edema and neck vein distention occur with superior vena cava syndrome.