Chemotherapy works by killing both normal and cancerous cells, altering their DNA. It is administered intravenously, intrathecally, or orally. Treatment protocols consider the cancer type, location, and drugs/doses. Common side effects include hair loss, mouth sores, bone marrow suppression, nausea, and weight loss. Nursing care focuses on preventing infection due to immunosuppression and supporting coping and nutrition during treatment.

1. 1
Pediatric Chemotherapy
Gina Brandl, RN BSN, MSN-Cand
Nursing Instructor
MSTC - Pediatrics

2. 2
Objectives
• The student will describe how chemotherapy
works on cells normal and cancerous cells
• The student will describe the common side
effects of chemotherapy
• The student will assist in developing a nursing
care plan appropriate for the pediatric
patient receiving chemotherapy

3. 3
Chemotherapy
• Chemotherapy
– Specific drugs
• Kill normal and cancerous cells
• Given simultaneously
– Achieves greatest cellular destruction
• Alters DNA
– Administration
• Intrathecal (into spinal canal), oral or
intravenous

4. 4
Protocols
• Type of cancer
• Cell type
• Location and spread
• Drug
• Dose
• Interval of treatment
Treatment for side effects
Necessary laboratory studies
(London et al., 2007)

5. 5
Other Drugs Used
• Other drugs used in cancer treatment
– Colony-stimulating factor
• Erythropoietin (Epoetin)
• Filgrastim (Neupogen)
– Antimetics
• Ondansetron (Zofran)
– Nutritional supports
• Help to maintain nutritional support
– TPN & Lipids

6. 6
Side Effects of Chemotherapy
• Occur when healthy cells are damaged
– Occurrence
• Immediately
• Week to ten days
• Months to years
– Permanent or temporary
– Includes: hair loss, mouth sores,
constipation, bone marrow suppression,
nausea and emesis, anorexia and weight loss

7. 7
Side Effects of Chemotherapy
• Hair loss
• Mouth sores
• Pain
• Constipation
• Bone marrow
suppression
• Nausea and vomiting
• Anorexia and weight
loss

8. 8
Nursing Care Plan
• Nursing diagnosis
– Risk for infection r/t immunosupression,
invasive procedures, malnutrition, or
pharmaceutical agents
• Goals, interventions with rationale and expected
outcomes
– Ineffective individual coping r/t situational
crisis
• Goals, interventions with rationale and expected
outcomes

9. 9
References
London, M. L., Ladewig, P. W., Ball, J. W., & Bindler, R. C.
(2007). Maternal & child nursing care (2nd ed.). Upper
Saddle River, NJ: Prentice Hall.
Saint Joseph’s Hospital. (2006). Pediatric oncology – Education
& resource guide. Marshfield, WI; Ministry Health Care
Steinbrook, R. (2007). Erthropoietin, the FDA, and oncology.
The New England Journal of Medicine. 356(24), p. 248.
Retrieved December 16, 2007, from the website
http:proquest.umi.com.ezproxy.apollolibrary.com/pqdweb?did=
128822401901&sid=6&Fmt=3&clientid=13118&RQT=309&VNa
me=PQD