CANCER Flashcards
The higher the growth factor, the ____.
more cancer cells will be killed!
what is intrathecal?
in the subarachoid space (spine)
magic number for RBC?
hemoglobin between 10-12
magic number for neutrophils?
keep above 1500
magic number for platelets?
keep above 50000
what cancer drug is known for cardiac toxicity?
doxorubican
what cancer drug is known for kidney failure
cisplatin
monitor blood in urine. check UA 1st!
what drug do you give before chemo drug to protect the bladder?(hemorrhagic cystitis)
mesna
you should advise no pregnancy during chemo and ____ after chemo.
3-6 months
what chemo drug is known for peripheral neuropathy?
vincristine
monitor for numbness, tingling in periphery
what chemo drug is known for hearing loss?
cisplatin
what chemo drug is known for pulmonary fibrosis?
carmustin
what chemo drug is known for myelosuppression?
methotrexate
what chemo drug is known for hemorragic cystitis?
cycloPhsphamide
major AE for cyclophosphamide?
alopecia
others are: GI effects bone marrow suppresion kidney toxicity electrolyte imbalance
When there are severe GI effects, what should you do as a nurse?
give antimetics!!!!
premedicate with antimetics!
a patient has chest pain with dyspnea. what could this be a description of?
pulmonary fibrosis!
(scarring of the lung) goes with carmustin!
this drug bonds to the cancer cells DNA, prevent DNA from going any further. STOPS replication of the cell.
carmustin
can cause serious injury to tissues and nerves–infection–loss of a limb
vesicant
major AE of cisplatin
ototoxicity
kidney toxicity
severe gi effects
paresthesia of extremities
**anaphylactic reaction
methotrexate works well with rapidly dividing cancer cells, but will also damage normal cells also. what drug will you give with methotrexate to prevent this?
leucovorin
leucovorin to the rescue!!
if women is pregnant, ___ can cause women to abort. (category X drug)
methotrexate
major AE for meracaptopurine?
bone marrow suppression
when a patient has bone suppression, what should you monitor for?
CBC, thrombocytes, HbT/HcT, infection, bleeding on common sites
if a patient is nuetropenic, what should you advise the patient?
wash fruits/veggies, cook food throughly avoid people who are ill oral care to prevent stomtitis report fever, sore thoart, easy bruising, unusual fatigue HANDWASHING
if a patient has a platelet deficit, what should advise the patient?
use soft toothbrush and electric razor; avoid brusing easy bruising bleeding; nose bleeds,gums or mouth tiny red spots on the skin blood in the urine dark or black bowel movement
if a patient has as RBC deficit (anemia), what should you advise the patient?
rest, pace yourself, fatigue paleness of skin, lips, and nail bed increased HR eary tiring with exertion dizziness
what is the 2 major things to remember wth cytarbine?
1. one of the administration s intrathecal use: can cause arachnoiditis (N/V, HA, fever) ADMINISTER DEXAMETHASONE (corticosteroid) for antiemetic for chem along with intrathecal cytarabine 2. interactions: do not give immunizations with live viruses during therapy for 3 months after therapy.
what drug can cause urine and sweat to be red for a few days?
what is the main AE for this drug?
doxoRUBicin
it is harmless
also doxorubicin is known for cardiac toxicity!
what drug can cause cateracts?
tamoxifen
should get baseline vision exam
what should we know about tamoxifen?
it is a SERM
can cause cateracts and uterine cancer and hot flashes
-prevents occurance of breast cancer is patients who are at high risk.
treats early or advanced estrogen receptor positive breast cancer in postmenopausal women only
anastrolzole
what is the major AE for anastrolzole?
osteoporosis
- increase intake of calcium and vit D
- take precautions to prevent falls if bone density is low
- increase weight-bearing exercise if possible
- do not smoke
should you take any other extra estrogen drug while taking anastrolzole?
NO
treats prostate cancer in early stages and after metastasis
flutamide
what is the major AE of flutamide?
gynecomastia (more feminine)
major AE for vincrisine?
peripheral neuropathy
constipation
what would you advise a patient wth constipation to do?
increase fluids and fiber
laxatives
stool softners
bradycardia usually lasts with this drug only during infusion? what would you do about this?
paclitaxel
monitor VS frequently
other AE is peripheral neuropathy,bone marrow suppression, allergic rxns
interferon alpha 2a and 2b, what is the major AE and what do you do about it?
flu like symptoms
pre medicate with acetamiphen
what drug is a monoclonal antibodie? what is the major AE for it?
trastuzumab alleregic reaction (intervene with epinephrine!)
A client with ovarian cancer is being treated with vincristine (Vincasar). The nurse monitors the client, knowing that which manifestation indicates an adverse effect specific to this medication?
- Diarrhea
- Hair loss
- Chest pain
- Peripheral neuropathy
4.Peripheral neuropathy
A client with metastatic breast cancer is receiving tamoxifen. The nurse specifically monitors which laboratory value while the client is taking this medication?
- Glucose level
- Calcium level
- Potassium level
- Prothrombin time
- Calcium level
The nurse is providing medication instructions to a client with breast cancer who is receiving cyclophosphamide. The nurse should tell the client to take which action?
- Take the medication with food.
- Increase fluid intake to 2000 to 3000 mL daily.
- Decrease sodium intake while taking the medication.
- Increase potassium intake while taking the medication.
- Increase fluid intake to 2000 to 3000 mL daily.
A client with testicular cancer is receiving cisplatin. The nurse assesses for which finding as a toxic effect of this medication?
- Tinnitus
- Diarrhea
- Nausea and vomiting
- Elevated white blood cell (WBC) count
- Tinnitus
The nurse caring for a client receiving vincristine (Oncovin) is monitoring the client for toxicity. The nurse interprets that the client is experiencing a toxic effect of this medication on the basis of which assessment finding?
- Nausea and vomiting
- Decreased platelet count
- Decreased white blood cell count
- Weakness and sensory loss in the legs
- Weakness and sensory loss in the legs
A female client with a diagnosis of breast cancer is taking cyclophosphamide. The client calls the health care clinic and tells the nurse that the medication is upsetting her stomach. Which instruction should the nurse provide to the client?
- Take the medication with food.
- Avoid drinking fluids while taking the medication.
- Try to take the medication with a small amount of orange juice.
- Continue to take the medication on an empty stomach, and lie down after taking the medication
- Take the medication with food.
The nurse is monitoring a client with leukemia who is receiving doxorubicin (Adriamycin PFS) by intravenous infusion. The nurse should monitor for which assessment finding that would indicate toxicity to the medication?
- Elevated creatinine
- Red coloration in the urine
- Elevated blood urea nitrogen
- Electrocardiogram (ECG) changes
- Electrocardiogram (ECG) changes
A female client with carcinoma of the breast is admitted to the hospital for treatment with intravenously administered doxorubicin (Adriamycin). The client tells the nurse she has been told by her friends that she is going to lose all her hair. What is the appropriate nursing response?
- “Your friends are correct.”
- “You will not lose your hair.”
- “Hair loss may occur, but it will grow back just as it is now.”
- “Hair loss may occur, and it will grow back, but it may have a different color or texture.”
- “Hair loss may occur, and it will grow back, but it may have a different color or texture.”
The client with bladder cancer is receiving cisplatin and vincristine (Vincasar PFS). The nurse preparing to give the medication understands that which is the purpose of administering both of these medications?
- To prevent alopecia
- To decrease the destruction of cells
- To increase the therapeutic response
- To prevent gastrointestinal side effects
- To increase the therapeutic response
A client with lung cancer is receiving a high dose of methotrexate (Trexall). Leucovorin (citrovorum factor, folic acid) is also prescribed. The nurse planning care for the client should understand that the purpose of administering the leucovorin is to promote which action?
- Preserve normal cells.
- Promote DNA synthesis.
- Enable medication excretion.
- Facilitate the synthesis of nucleic acids.
- Preserve normal cells.
The nurse reviewing a medical record notes that high concentrations of methotrexate followed by leucovorin (citrovorum factor, folic acid) are being given to the client with cancer. The nurse correctly interprets that which is the reason for therapy with leucovorin?
- Preserve normal cells.
- Promote protein synthesis.
- Promote medication excretion.
- Hasten the effect of the methotrexate.
- Preserve normal cells
A client who has been diagnosed with cancer is to receive chemotherapy with both cisplatin (Platinol-AQ) and vincristine (Oncovin). The client asks the nurse why both medications must be given together. The nurse’s response is based on the understanding that the purpose of using both medications is to promote which action?
- Increase the destruction of tumor cells.
- Prevent the destruction of normal cells.
- Decrease the risk of the alopecia and stomatitis.
- Increase the likelihood of erythrocyte and leukocyte recovery.
- Increase the destruction of tumor cells.
The client with breast cancer has been given a prescription for cyclophosphamide. The nurse determines that the client understands the proper use of the medication if the client states that he or she will take which measure?
- Increase dietary intake of potassium.
- Increase fluid intake to 2 to 3 L/day.
- Take the medication with large meals.
- Decrease dietary intake of magnesium.
- Increase fluid intake to 2 to 3 L/day.
The nurse should be prepared to institute bleeding precautions in the client receiving antineoplastic medication if which result was reported from the laboratory?
- Clotting time 12 seconds
- Ammonia level 28 mcg/dL
- Platelet count 50,000 cells/mm3
- White blood cell count (WBC) 4500 cells/mm3
- Platelet count 50,000 cells/mm3
A nurse is assigned to care for a client with metastatic breast cancer who is taking tamoxifen citrate. The nurse plans to monitor for which changes in laboratory values for this client? Select all that apply.
- Increase in lipase level
- Increase in blood glucose level
- Increase in serum calcium level
- Increase in serum potassium level
- Decrease in low-density lipoprotein levels
3 and 5
The nurse educator at a hospital is teaching a patient education class about the characteristics of neoplastic cells. To evaluate understanding, the nurse asks, “What is the most distinguishing property of an invasive growth?” Which response by a participant demonstrates a need for further teaching?
a. “Unrestrained growth and division; malignant cells are unresponsive to feedback mechanisms.”
b. “Normal tissues remain segregated and don’t invade other tissues.”
c. ”Division of neoplastic cells always occurs rapidly.”
d. “Malignant cells are free of constraints that inhibit invasive growth and can penetrate adjacent tissues.”
c. ”Division of neoplastic cells always occurs rapidly.
After undergoing chemotherapy, a patient has excessive levels of uric acid in the blood. What are the implications for nursing, and what intervention should the nurse expect?
a. The hyperuricemia may cause liver damage; chemotherapy should be withdrawn until the hyperuricemia resolves.
b. The hyperuricemia can contribute to a high risk of thrombocytopenia; heparin should be administered to prevent thrombus.
c. The hyperuricemia may injure the kidneys; allopurinol (Zyloprim) should be administered.
d. The hyperuricemia will result in further immunosuppression; the patient should be prepared for dialysis.
c. The hyperuricemia may injure the kidneys; allopurinol (Zyloprim) should be administered
The nurse is preparing to administer medication to a patient receiving cyclophosphamide (Cytoxan). To protect against the side effect of hemorrhagic cystitis, the nurse would expect to administer
a. Decadron.
b. diphenhydramine (Benadryl).
c. mesna (Mesnex).
d. leucovorin.
C.
MESNA
A 43-year-old woman with a strong family history of breast cancer considers tamoxifen (Nolvadex) for cancer prevention. Which assessment finding is a possible contraindication?
a. History of deep vein thrombosis (DVT)
b. Prior hysterectomy
c. History of osteoporosis
d. Hyperlipidemia
a. History of deep vein thrombosis (DVT)
A male patient has been admitted to the oncology unit for the treatment of prostate cancer. The nurse receives an order to start the patient on flutamide (Eulexin) therapy. The nurse will want to monitor which of the following?
a. Liver enzymes
b. Serum creatinine
c. Lipid profile
d. Complete blood cell count
a. Liver enzymes
The nurse at a chemotherapy clinic is preparing to administer interferon alfa to a patient. To help minimize side effects, the nurse may
a. start oxygen.
b. lower the ambient temperature.
c. provide antiemetics.
d. administer acetaminophen.
d. administer acetaminophen.
