Basic

Question 1

Extravasation

Answer 1

vesicant agent infiltrates into the tissue surrounding the vein and causes cellular damage or tissue destruction

Question 2

irritant agent

Answer 2

medication that can cause pain and inflammation at the administration site or along the path of the vein that is used

Question 3

treatment protocol

Answer 3

a “recipe” that defines the drug combinations that will be used to treat a specific cancer, including:
- standard dose of the drug
- the administration frequency of the drug
- the time interval between drugs
- the treatment for side effects
- routine monitoring
- the laboratory tests

Question 4

Infections in BMT setting

Answer 4

results from:
1. neutropenia
2. depressed T- and B-1 lymphocyte function
3. disruption of anatomic barriers
4. immunosuppressive agents used to manage GVHD

Most common sites:
1. GI tract
2. oropharynx
3. lung
4. skin
5. indwelling catheter sites

Prophylaxis:
1. handwashing
2. meticulous oral hygiene
3. prophylactic anti-fungal/viral drug
4. protective isolation

Treatment:
1. prompt initiation of Abx therapy in febrile neutropenic pts
2. identifying the invasive organism
3. treating the accompanying infection with appropriate Abx

Manifested by FEVER AND SHAKES (RIGORS)
To resolve: WHITE CELL RECOVERY is critical

Abx related side effects:
1. skin rash
2. nausea
3. liver/kidney dysfunction
4. diarrhea (eg. Abx induced overgrowth of C.diff)

Question 5

Abx effectiveness in BMT

Answer 5

• reduction of fever
• subjective improvement in other signs of infection with 2-3 days (pt states they feel well)
• blood cultures remain or become NEGATIVE

Question 6

Abx related side effects:

Answer 6

1. skin rash
2. nausea
3. liver/kidney dysfunction
4. diarrhea (eg. Abx induced overgrowth of C.diff)

Question 7

Aspergillus

Answer 7

• a fungus that usually affects the lungs or sinuses
• most common life-threatening infection in BMT pts
• some pts already have this organism in body at the time of hospitalization

HEPA filtration is utilized to filter it out

Question 8

Problems associated with use of Abx

Answer 8

• immunocompromised pts that at an increased risk for infection may respond POORLY to Abx
• bacteria develops resistance to Abx
• Abx toxicities
• specific damage produced by Abx
• Abx induces allergic response

Question 9

S&S of allergic reactions

Answer 9

• maculopapular rash (red bumps on a flat, red patch of skin)
• urticaria (hives)
• pruritus
• difficulty breathing

Question 10

Interventions when allergic reactions occur

Answer 10

• stop the drug immediately
• administer Epinephrine, antihistamines, corticosteroids
• may require assisted ventilation

Question 11

Interventions when diarrhea occurs

Answer 11

• collect a sample for C.diff toxin assay
• notify Dr.

**at VGH, lab will not run a specimen if c.diff is done WITHIN the last 7 days.