six good-risk (22%), nine average-risk (32%), and nine poor-risk patients (32%); four patients (14% ) had leukemia-lymphoma. Parents’ impressions of the consent process and level of anxiety were analyzed using descriptive statistics; readability of consent forms was assessed using the Fry Scale. Although parents’ mean state anxiety was significantly increased above the mean norms, the majority indicated that explanations of benefits and risks were fairly clear, and that they had adequate time to consider treatment and ask questions. For mothers, but not fathers, the higher their anxiety the less likely they were to feel that adequate time was provided before signing the consent form (P = 100), liver failure (LDH >500, SGOT >150), and elevation of products of protein metabolism (triglycerides, glutamate, lactate, alanine). Rapid, coordinated intervention can provide a positive outcome.
is at least as important as the treatment of septic shock. Empiric therapy with broad antibiotics are given to patients with low absolute neutrophil counts and any symptom of spectrum infection. Aggressive management of potential shock is instituted whenever early symptoms of shock are recognized including: hyperthermia (or hypothermia); tachycardia; tachypnea; hypotension; decreased urine output; peripheral cyanosis; cold, clammy extremities; our mental changes (irritability, restlessness, confusion). Recognizing the underlying cause of a particular symptom is crucial to early intervention and prevention of progression to shock.
Summary Considering the progress toward more aggressive therapies in the treatment of childhood cancer, patients will be placed at risk of serious infection for longer periods of time. Nurses will inevitably encounter patients in septic shock. Clear communication of objective and subjective patient data, followed by prompt intervention, is essential to successful treatment and positive patient outcomes. more
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