Introduction: Chemotherapy is a fundamental treatment for childhood malignancies, but its effects on healthy, rapidly dividing cells may cause numerous adverse effects. The resulting physical and psychological problems can affect the child’s well-being, treatment course, and family’s quality of life. Early recognition and appropriate management are therefore essential parts of comprehensive paediatric oncology care. Purpose: The purpose was to review the most common adverse effects of chemotherapy in children and the role of nurses in their prevention, recognition, monitoring, and management. Particular attention was given to chemotherapy-induced nausea and vomiting and oral mucositis. Methods: A descriptive review of Slovenian and international professional and scientific literature was conducted. Searches were performed in the Cumulative Index to Nursing and Allied Health Literature and PubMed databases, Google Scholar and the Digital Library of the University of Ljubljana. The following English keywords were used: chemotherapy, adverse effects, side effects, toxicity, symptoms, nausea, vomiting, oral mucositis, children, pediatric patients, pediatric oncology, oncology nursing, nurse, nursing care in caregiver. Sources were selected according to predefined content and publication-date criteria. Results: The final review and analysis included 11 studies. We found that common adverse effects of chemotherapy in children included neutropenia, thrombocytopenia, nausea and vomiting, diarrhoea, and oral mucositis. Despite antiemetic treatment, nausea and vomiting were not always adequately controlled. Their occurrence was influenced by child-, treatment-, and environment-related factors. Regular oral assessment, appropriate oral care, and timely relief of pain and eating difficulties were important in preventing and managing oral mucositis. Planned education improved parents’ knowledge of adverse-effect management, while systematic symptom monitoring reduced the overall symptom burden. Differences were also found between children’s experiences of symptoms and nurses’ assessments. Discussion and conclusion: The management of chemotherapy-related adverse effects requires individualised, comprehensive, and child-centred nursing care. Nurses play an important role in monitoring the child’s health, recognising changes early, implementing supportive interventions, and educating children and their parents. In addition to professional assessment, nurses should consider the child’s own experience of symptoms and encourage family involvement. Collaboration among the child, parents, nurses, and other healthcare team members contributes to safer and more effective management of adverse effects.
Keywords: paediatric oncology, nausea, vomiting, oral mucositis, nursing care
|
