Pediatric Hematologic & Oncologic Disorders: Sickle Cell Anemia, Leukemia, and Childhood Cancer Explained | Chapter 29 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

Welcome to Chapter 29 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri. This chapter provides a focused review of pediatric hematologic and oncologic disorders—including anemias, hemophilia, and common childhood cancers—empowering nursing students with the knowledge needed for NCLEX success and safe, evidence-based clinical practice.

Watch the full video summary below and subscribe to Last Minute Lecture for more high-yield pediatric hematology and oncology content:

Sickle Cell Anemia: Pathophysiology, Crisis Types, and Nursing Interventions

• Pathophysiology: Inherited disorder causing sickling of red blood cells, impaired oxygen transport, and vessel occlusion.
• Crisis Types: Vaso-occlusive (painful), splenic sequestration, aplastic, hyperhemolytic.
• Key Nursing Care: Hydration, oxygenation, pain management (often opioids), infection prevention, and monitoring for acute chest syndrome or stroke. Educate on triggers and early signs of crisis.

Iron Deficiency and Aplastic Anemia: Recognition and Management

• Iron Deficiency: Most common anemia in children. Symptoms include fatigue, pallor, and irritability. Treat with iron-rich foods (meat, leafy greens), supplements (Z-track method for IM), and safe storage away from children.
• Aplastic Anemia: Pancytopenia due to bone marrow failure. Interventions include immunosuppressive therapy, infection precautions, transfusions, and possible bone marrow transplantation.

Hemophilia and von Willebrand Disease: Bleeding Disorders in Pediatrics

• Hemophilia: X-linked disorder (usually Factor VIII or IX deficiency). Presents as joint bleeding (hemarthrosis), easy bruising, and bleeding after trauma. Treatment includes factor replacement, DDAVP, bleeding precautions, and joint protection.
• von Willebrand Disease: Impaired platelet adhesion, mucosal bleeding. Similar management to hemophilia, often with DDAVP and factor replacement. Emphasize Med-Alert bracelet and injury prevention.

β-Thalassemia Major: Severe Anemia and Transfusion Protocols

• Characterized by ineffective hemoglobin synthesis and chronic hemolysis. Signs include severe pallor, frontal bossing, growth retardation, and hepatosplenomegaly.
• Care includes regular blood transfusions, chelation therapy to prevent iron overload, and genetic counseling for families.

Childhood Cancer: Leukemia, Lymphoma, and Solid Tumors

• Leukemia (ALL): Bone marrow suppression, increased infection and bleeding risk, and chemotherapy side effects (mucositis, alopecia, nausea). Monitor for fever, bruising, and mouth care needs.
• Hodgkin’s Disease: Painless lymphadenopathy, Reed-Sternberg cells on biopsy, managed with chemo and radiation.
• Wilms' Tumor: Renal tumor; do not palpate the abdomen due to risk of tumor rupture. Treatment includes nephrectomy, chemotherapy, and radiation.
• Neuroblastoma: Adrenal or sympathetic nervous system tumor, often metastatic. Requires multimodal therapy and family emotional support.
• Osteosarcoma: Bone pain, swelling, and risk for fractures. May require limb-sparing surgery or amputation, chemotherapy, and prosthesis education.
• Brain Tumors: Watch for signs of increased intracranial pressure (vomiting, headache, change in behavior), surgical intervention, chemo, and radiation. Post-op care includes head positioning and CSF leak monitoring.

Safety Priorities, Family Education, and NCLEX Alerts

• Strict infection and bleeding precautions for immunosuppressed children and those on chemotherapy.
• Post-op and post-chemo monitoring for hemorrhage, infection, and CSF leaks.
• Family teaching: medication side effects, central line care, nutritional support, genetic counseling, and access to community resources.
• Supportive care: pain management, emotional support, prosthetic/rehab resources, and end-of-life counseling if indicated.

For in-depth scenarios, stepwise interventions, and NCLEX-style questions on pediatric hematologic and oncologic disorders, watch the full video and subscribe to Last Minute Lecture for chapter-by-chapter mastery!

Conclusion: Mastering Pediatric Hematology & Oncology for NCLEX-PN

Understanding the pathophysiology, assessment, and safe nursing care of anemia, bleeding disorders, and pediatric cancers is essential for NCLEX-PN success. This chapter equips students to recognize symptoms, implement priority interventions, and educate families—ensuring safe, effective care for children with complex hematologic or oncologic needs.

If you found this breakdown helpful, be sure to subscribe to Last Minute Lecture for more chapter-by-chapter textbook summaries and academic study guides.

Explore the entire YouTube playlist for Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) here: Complete Playlist