Blood Tests Blood tests are done to monitor your child’s blood cells, body salts, and chemistries. Blood tests are very helpful in diagnosing medical problems and monitoring for side effects of treatment. A specially trained nurse or technician uses a needle to enter a vein and collect a blood sample in tubes that are then sent to a laboratory where they are examined closely. In some cases, a finger prick may give enough blood for a test. These tests are usually done at the time of diagnosis to rule out other diseases and to serve as a baseline for your child. Blood tests are used throughout treatment to monitor for possible side effects and your child’s response to treatment. Blood tests such as creatinine and blood urea nitrogen (BUN) monitor changes in kidney function. Blood tests called hepatic function panel and bilirubin detect changes in liver function. Alkaline phosphate and lactic dehydrogenase (LDH) levels may be high in the blood due to bone growth from a tumor. Complete Blood Count Blood is made up of plasma (the liquid part of the blood) and cells that are floating in the plasma. There are three types of blood cells: white blood cells, red blood cells, and platelets. The white blood cells fight infection as part of the body’s immune system. The red blood cells carry oxygen to all cells of the body. The platelets stop bleeding by rushing to the site of an injury and forming a clot. A complete blood count , or CBC, is a blood test used to measure the amount and the health of these three types of cells. The CBC is useful in diagnosing blood disorders that a child has inherited or developed. A CBC’s results may change due to other things going on in the body, such as infections, nutritional problems, or as a response to some medications like chemotherapy. Venous Access Device (VAD) A venous access device (VAD), sometimes called a central venous cathete r, is a temporary or long-term intravenous (IV) tube that can be used for the duration of your child’s treatment. It is placed in a large vein in the chest or the arm. These long, flexible catheters empty into or near the heart, allowing necessary treatments to be given within seconds. It can be used to administer medications, IV fluids, chemotherapy, blood products, and nutritional support when needed, as well as to draw blood for testing. It is inserted during surgery while your child is sedated or has been given general anesthesia, either before chemotherapy begins or within the first month of treatment. Not all children need a VAD. This is determined by you and your healthcare team. The VAD will be removed when it is no longer needed. There are different types of VADs, such as an implanted port inserted under the skin near the collarbone, a tunneled central venous catheter (Broviac® or Hickman®) that has a tube, a lumen (either double or single) which comes out of your child’s chest, or a PICC line (a central line inserted through a vein in the arm). Your healthcare team will discuss each type with you and help you choose the best device for your child’s treatment. The care for each of these types of catheters is slightly different. A port requires almost no care at home but a special needle (noncoring) will need to be inserted through the skin
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