26:T49d,

Children with brain tumors routinely undergo craniotomies for tumor resections. Nurses and nurse practitioners are critical in closely monitoring these patients. Postoperatively, these children may develop inappropriate vasopressin secretion, cerebral salt wasting syndrome, or a combination of both. Inappropriate fluid and electrolyte administration may exacerbate symptoms. Both high and low sodium levels are associated with significant complications. Sodium levels were prospectively observed for 72 hours perioperatively. Overall, 36 patients had 201 serum sodium levels measured over the course of 1 year. Postoperatively, 79 (39%) of the sodium levels were <135 mEq/L or >145 mEq/L. Of these abnormal sodium levels, 3 (1%) were <125 mEq/L and 2 (1%) were >165 mEq/L. All the abnormal sodium levels occurred in patients with suprasellar or hypothalamic lesions. This study suggests that children with resections of suprasellar or hypothalamic tumors need specialist attention in postoperative management of fluid and electrolytes. The nurse is in the ideal role to monitor closely the pediatric brain tumor patient at high risk for abnormal sodium levels.

27:T4cd,

Background. For clinicians to effectively help children with their illness and symptoms, it is important to communicate with them in a language they can understand. Methods. This study investigates how well children with cancer and healthy children understood 44 symptom terms; their thoughts about these symptoms in terms of causes, consequences, and cures; and what other terms the children use to express these symptoms. It also explores if there are differences in understanding and thoughts about symptoms between children who have the experience of cancer and those who do not. In all, 6 children with cancer and 8 healthy children participated in semistructured interviews. Results. Children demonstrated a good understanding of symptom terms, yet were not always able to explain the symptoms. They had a rich vocabulary to talk about symptoms but did not use childish terms. Children with cancer had a more varied vocabulary for symptoms, but they did not use more medical terms.This study contributes to knowledge about children’s understanding of symptoms that can be helpful to clinicians when communicating with children about their illness.

28:T57c,