Osteogenic sarcoma (Osteosarcoma) is a primary bone malignancy that usually affects the metaphysics of the long bones (femur, humerus, and tibia). The most common symptoms of osteosarcoma are dull aching pain and swelling in the bone or joint around the tumor. The disease most commonly occurs in children, teenagers, and young adults between the ages of 10 and 20 and it is prevalent in males than females.
Management consists of a combination of treatment that includes amputation of the limb with chemotherapy before and/or following surgery, or a bone and joint prosthesis in selected children to restore the limb with chemotherapy prior the surgery.
Nursing Care Plans
Care plan for a child with osteosarcoma includes prevention of injury, improved condition of oral mucous membranes, relief from anxiety and absence of complications.
Here are four (4) nursing care plans (NCP) for osteogenic sarcoma (Osteosarcoma):
Ineffective Protection
Ineffective Protection: Decrease in the ability to guard self from internal or external threats such as illness or injury.
May be related to
- Antineoplastic medication
- Abnormal blood profile (leukopenia, thrombocytopenia, anemia, coagulation)
Possibly evidenced by
- Altered blood coagulation
- Bone marrow suppression
- Impaired immunity against infection
- Hematoma, petechiae, hematochezia, hematemesis, bleeding from nose or gums.
Desired Outcome
- Child will not experience bleeding episode.
- Child’s temperature will remain <100° F
- Child’s breath sounds will be clear bilaterally.
| Nursing Interventions | Rationale |
|---|---|
| Monitor for any signs of bleeding and febrile episodes; Note laboratory findings: WBC, platelet count, Hct, and absolute neutrophil count. | Provides knowledge on any obvious, visible presence of bleeding or abnormal blood profile that predispose to bleeding due to bone marrow suppression and immunosuppression resulting from chemotherapy. |
| Inform parents and child to avoid exposure to people with upper respiratory infection or any illness. | Prevents a highly susceptible child to acquire an infection. |
| Encourage parents and child to avoid contact play or sports, straining at defecation, forcefully blowing nose. | Prevents injury that may possibly result in bleeding. |
| Inform parents to notify health care provider for signs of increased temperature, changes in behavior, headache, dizziness, fatigue, pallor, bleeding episode, exposure to a communicable disease. | Signifies a complication related to an abnormal blood profile. |
| Teach handwashing technique before providing care, using of protective gear such as mask and gown when appropriate, providing a private room, monitor for any signs and symptoms of infections. | Prevents transmission of a microorganism to a compromised immune system during chemotherapy if neutrophil count is less than 1,000/cu mm. |
| Discourage the use of hard toothbrush, obtaining rectal temperatures, undergoing unnecessary invasive procedures. | Prevents the occurrence of bleeding caused by during chemotherapy which alters platelet and clotting factors. |
| Teach and demonstrate on how to get urine and stool sample using dipstick and hematest. | Determines the presence of bleeding in the gastrointestinal or urinary tract. |
See Also
You may also like the following posts and care plans:
- 1,000+ Nursing Care Plans List – the ultimate database of nursing care plans for different diseases and conditions! Get the complete list!
- What is a Nursing Care Plan? 9 Steps on How to Write a Care Plan – learn how to write an excellent care plan. We explain the concepts and walk you through the steps.
- Nursing Diagnosis: The Complete List – archive of different nursing diagnoses with their definition, related factors, goals and nursing interventions with rationale.
- The Ultimate Guide to Nursing Diagnosis – learn how to formulate nursing diagnoses correctly in this easy-to-follow guide!
Pediatric Nursing Care Plans
Nursing care plans for pediatric conditions and diseases:
- Acute Glomerulonephritis | 4 Care Plans
- Acute Rheumatic Fever | 4 Care Plans
- Apnea | 4 Care Plans
- Brain Tumor | 3 Care Plans
- Bronchiolitis | 5 Care Plans
- Cardiac Catheterization | 4 Care Plans
- Cerebral Palsy | 7 Care Plans
- Child Abuse | 4 Care Plans
- Cleft Lip and Cleft Palate | 6 Care Plans
- Congenital Heart Disease | 5 Care Plans
- Congenital Hip Dysplasia | 4 Care Plans
- Croup Syndrome | 5 Care Plans
- Cryptorchidism (Undescended Testes) | 3 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Diabetes Mellitus Type 1 (Juvenile Diabetes) | 4 Care Plans
- Dying Child | 4 Care Plans
- Epiglottitis | 5 Care Plans
- Febrile Seizure | 4 Care Plans
- Guillain-Barre Syndrome | 6 Care Plans
- Hospitalized Child | 5 Care Plans
- Hydrocephalus | 5 Care Plans
- Hypospadias and Epispadias | 4 Care Plans
- Intussusception | 3 Care Plans
- Juvenile Rheumatoid Arthritis | 4 Care Plans
- Kawasaki Disease | 6 Care Plans
- Meningitis | 7 Care Plans
- Nephrotic Syndrome | 5 Care Plans
- Osteogenic Sarcoma (Osteosarcoma) | 4 Care Plans
- Otitis Media | 4 Care Plans
- Scoliosis | 4 Care Plans
- Spina Bifida | 7 Care Plans
- Tonsillitis and Adenoiditis | 4 Care Plans
- Umbilical and Inguinal Hernia | 4 Care Plans
- Vesicoureteral Reflux (VUR) | 5 Care Plans
- Wilms Tumor (Nephroblastoma) | 4 Care Plans
Further Reading
Recommended books and resources:
- Nursing Care Plans: Diagnoses, Interventions, and Outcomes
- Nurse's Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
- Nursing Diagnoses 2015-17: Definitions and Classification
- Diagnostic and Statistical Manual of Mental Disorders (DSM-V-TR)
- Manual of Psychiatric Nursing Care Planning
- Maternal Newborn Nursing Care Plans
- Delmar's Maternal-Infant Nursing Care Plans, 2nd Edition
- Maternal Newborn Nursing Care Plans
