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OSTEOSARCOMA

Type of bone cancer that develops in the cells (forms the outer covering of the bone). Most common and fatal in children and males between 10-25 years old. 5% of all childhood cancers.

Common sites: long bones, knee, upper leg, thigh bone, lower leg and upper arm. Etiology Causes: Unknown DNA mutation either inherited or acquired after birth. Familial susceptibility Injury Infection

Metabolic or hormonal disturbance Risk Factors: Children Teenage growth spurt Tall for the age Previous treatment with radiation

Benign and non-cancerous bone tumors Retinoblastoma Adult High fat diet Lack of exercise Smoking

Drinking alcohol Pathophysiology Osteoblast DNA mutation Malignant osteoblast (abnormal) Proliferation of abnormal osteoblast

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5. Formation of osteoid or immature bone 6. Signs and symptoms are then observed such as pain, swelling, and tenderness. Assessment 1. 2. 3. 4. 5. Encourage patient to discuss problem and course of symptoms. Note patient and familys understanding of the disease, coping with the problem and management of pain. Palpate mass gently on physical examination. Note size and associated soft-tissue swelling, pain and tenderness of the mass. Assess neuromascular status and range of motion extremity.

6. Evaluate motility and ability to perform activities of daily living. Diagnostic Procedures

X-ray MRI CT scan Biopsy CBC Blood chemistry Urine analysis

Sternal marrow puncture Nursing Diagnosis Acute or chronic pain Risk for injury: pathologic fracture related to tumor Ineffective coping

Activity intolerance Nursing Intervention Provide quiet environment and calm activities to prevent or lessen pain. Provide comfort measure such as back rub, change position and use of heat or cold application. Encourage diversional activities Administer analgesics as indicated to maximal dose as needed. Encourage the patient to increase fluid intake. Encourage rest periods to prevent fatigue. Provide accurate information about the situation, medication and treatment. Assess muscle strength, gross and fine motor coordination.

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9. Provide pillows for cushion and support. 10. Keep side rails up all the time. Complications

Alopecia Reduction in number of leucocytes and platelets Septicemia Bleeding Anemia Kidney damage Hearing loss

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