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wilm’s tumors Risk factors of
- 12. Age Race Gender Family history Certain genetic factorsBirth defects WAGR Syndrome Beck with-Weidman syndrome Denys-Drash Syndrome
- 13. Bloom syndrome Soto’s syndrome Perlman syndrome
- 14. Aniridia Hemi hypertrophy Cryptorchidism Hypospadias
- 15. Tumors arise from renal parenchyma in either central or polar location ↓ Tumor may be a rim of compressed normal tissue ↓ Expanding mass surrounded by pseudo capsule of connective tissue ↓ Appears to separate kidney tumor ↓ Tumor get encapsulated (thin& easily torn) ↓ Growth rapid ↓ Become ↓ Vascular, soft, gelations&necrotic in the center
- 16. Fever Nausea Loss of appetite Short ness of breathing Constipation Without pain a mass in abdomen Swelling or a hard mass in the abdomen
- 17. Medical History and physical examination Imaging test Ultrasound (sono gram) CTscan MRIscan Chest X-ray Bone scan Lab tests Kidney biopsy
- 18. This system describes wilm’s tumor stages using Roman numbers I to V STAGE I:- The tumor within the kidney and was completely removed by surgery. STAGE II:- The tumor has grown beyond the kidney. About 20% of all wilms tumors are stage-2. STAGE III:- The tumor has spread to lympnodes in the abdomen or pelvis. STAGE IV:- The cancer has spared through the blood to organs away from the kidneys such has the LUNGS, LIVER, BRAIN or BONE, or to LUMPH NODES four away from the body. STAGE V:- Tumors are found in both kidneys at stage V
- 20. There are 3 types 1. Chemotherapy 2. Surgery 3. Radiation therapy
- 21. Under the chemo the drugs used for six months The drugs are Actinomycin-D Vincristine Doxorubicin Cyclophosphamide Carboplatin
- 22. Dose:- 15mg /kg daily by intravenous route for 5days. Action:- It is antibiotic obtained from species of Streptomyces. It is very toxic and hence its use is limited
- 23. Inhibition of mitotic spindles, they are obtained from the periwinkleplant, rosea, vinca. Uses:- Hodgkin’s disease and acute lymphatic leukemia.
- 24. The drugs affect rapidly growingcells and produce the bonemarrow depression leading to leucopnia, anemia and thrombocytopenia
- 25. Hair loss Mouth sores Loss of appetite Nausea and Vomiting Diarrhea
- 26. Remove the kidney Radical nephrectomy Partial nephrectomy Surgical Exploration
- 28. Injuries to major Blood Reaction to Anesthesia Internal Bleeding Infections
- 29. Radiation Therapy uses high- energy rays, or particles to kill cancer cells. Newer radiation techniques:- 3D-CRT IMRT
- 30. Damage the ovaries Hair loss Skin reactions Nausea
- 31. Reduced kidney functions Heart or lung problems Slowed or delayed growth and development Increased risk of Second cancers later in life
- 32. NURSING MANAGEMENT NURSING DIAGNOSIS Altered thermoregulation of body temperature r/t to infections as evidenced by checking vital signs. GOAL To reduced temperature INTERVENTION Provide comfortable position. Assess the fever characteristics. Provide cold compress of the body
- 33. In effective air way clearance related to broncho spasm as evidenced by breath less ness. GOAL To improve breathing pattern. Intervention Assess the breathing pattern Provide the O2 inhalation or nebulization Provide broncho dilators
- 34. Altered nutrition less than body requirements related to anorexia as evidenced by weight loss. GOAL To improve nutritional status. Intervention Assess the nutritional status of the client Monitor food intake not weight loss or weight gain Maintain favorable eating fluids as ordered
- 35. There is the remarkable correlation a among the DNA content in the cells of wilm’s tumor, histologic sub type, and treatment out come. Stem lines of both the primary tumor and Meta stases are in the diploid and low aneploid (hyper diploid) range
- 36. Introduction:- Nephrotic syndrome is primary a paediatric disorder and is 15 times more common in children than adults. Nephrotic syndrome is one of the common cause of hospitalization among children.
- 37. Definition:- Nephrotic syndrome is a symptom complex manifested by massive edema, hypoalbuminemia, marked albuminuria and hyper-lipidemia. “Parul data”. Nephrotic syndrome refers to a kidney disorder characterized by protenuria, hypoalbuminemia, and edema. “Jean weiler”.
- 38. The annual incidence of nephritic syndrome in the united states in children younger than 16years is 2 per 1,00,000 children (rother berg and heymann.1957; Schlesinger, 1968, sultz,1972) and cumulative prevalence is 16 per 1,00,000 children (Schlesinger,1968).
- 39. Congenital nephritic syndrome primary or idiopathic nephritic syndrome secondary nephritic syndrome
- 40. Genetic disorder:- Typical Nephrotic syndrome:- Finnish focal segmental glomerulo sclerosis Diffuse mesengial sclerosis Protinuria Multisystem Metabolic disorder
- 41. Minimal change disease Membranous nephropathy
- 42. Infections;- Hepatitis B&C HIV-1 Malaria Syphillis
- 43. Penicillamine Mercury Lithium.
- 44. Immunologic or Allergic disorder:- Foodallerges Associated withmalignent disease:- Lymphoma Leukemia Glomerular Hyper filtration:- Morbid Obesity
- 45. Primary Cause:- Conginital or genetic cause Membranous nephropathy Secondary cause:- Infections Drug reactions Haemolytic uremic syndrome
- 46. Alteration in the glomerulus Hypovolemia Increased reninproduction Reabsorption of sodium EDEMA
- 47. Ascites Pleural effusion Genital edema Anorexia Abdominal pain Diarrhea Vomiting Fatigue Lethergy Periorbital puffiness Profound weight gain Respiratory Distress Heamaturia Hepatomagaly
- 48. History of illness Physical Examination Laboratory investigations Urine Examination Blood examination Renal biopsy
- 49. Albumin infusion (1gm/kg/day) may be given in case of massive edema and ascites. Immunosuppressive drugs (levamisole, methotrexate, Cyclophosphamide, Cyclosporine, Chlorambucil) Prednisone at a dose of 2mg/kg/day Remission steroids Initiative therapy Cyclophosphamide or Chlorambucil Cyclosporine
- 50. Frusemide-1to3mg/kg/day in divided doses along with Spironolactone 2to mg/kg/day in two divided doses is given. Oral Penicilline
- 51. Nursing Diagnosis:- Risk for impaired skin integrity rt to edema and decreased circulation Goal:- To improved circulation Interventions:- Ensure that the child changes position every 2 hours Maintain good hygiene
- 52. Risk for infection rt to urinary loss of gamma globulins and immune suppressive therapy Goal:- To reduced infection Interventions:- Administered antibiotics as ordered Monitor child for fever, cough, and sore throat
- 53. Excess fluid volume rt to decreased excretion of sodium and fluid retention Goal:- To decreased fluid volume Interventions:- Monitor intake and output each shift Monitor blood pressure at least once each shift
- 54. Growth retardation, Renal Failure Thrombosis Recurrent infections Immune suppressive therapy Thrombosis Coagulation disorders Pleural effusion
- 55. Calcium and vitamin-D Deficiency Protein Energy malnutrition Relapse of Nephrotic Syndrome
- 56. The majority of children with steroid- responsive nephritic syndrome have repeated relapse. Which generally decreased in frequency as the child grows order. Although there is no proven way to predict an individual child’s course, those children who respond to steroids rapidly and those who have no relapse.
- 57. Over the past few decas, research in to wilm’s tumor has to great advances and much higher cure rates for this type of cancer. Still, not all children are cured, and even those who are cured might still have long-term side effects from treatment, so more research is needed. Research is continuing to unravel how changes in certain genes cause wilm’s tumors and affect how aggressive tumors are likely to be. Researches are also studying the gene changes that seem to cause wilm’s tumor cells to grow and spread. This may lead to treatments that specifically target these changes. Research continues to study ways to improve treatment for children with wilm’s tumors. As researches have learned more about the gene changes inwilms tumor cells. They have started to develop never drugs that specifically target these changes.