Cancer Treatment

Question 1

Tamoxifen - Class & MOA

Answer 1

• Class: Selective Estrogen Receptor Modulator (SERM)
• MOA: competes w/ estrogen binding sites in endocrine & reproductive tissues; may enhance estrogen effects in other systems

Question 2

Tamoxifen - Indications & Route

Answer 2

• Indications
  > breast cancer
  > prophylactic breast cancer
• Route
  > oral (may take for yrs)

Question 3

Tamoxifen - AEs & Cautions

Answer 3

• AEs
  > antiestrogen effects (hot flashes, menstrual irregularities)
  > masculinizing effects in women
  > risk VTE
• Cautions
  > pregnancy/breastfeeding
  > hx of blood clots

Question 4

Tamoxifen - Nursing Considerations

Answer 4

• Comfort measures to help pt cope w/ menopausal S/S such as hygiene measures, temp control, & stress reduction
• Educate manis of VTE

Question 5

Antineoplastic Agent General

Answer 5

• Harmful to all rapidly growing cells
• Narrow therapeutic index

Question 6

Antineoplastic Goals of Treatment

Answer 6

• Limit/dcr cancer cells so immune system can eliminate rest
• Limit toxicity to host

Question 7

Antineoplastic Caution

Answer 7

• Pregnancy/lactation
• Bone marrow suppression
• Hepatic or renal impairment
• CNS disorders

Question 8

Antineoplastic Routes

Answer 8

• Common: oral, IV
  > central vascular access device are commone (PICC or port)
• Nurses require certification to admin chemo

Question 9

General Actions of Antineoplastic

Answer 9

• Antagonize actions of key cellular metabolites needed for DNA synthesis
  > folic acid, purines, or pyrimidines
• Prevent mitosis (cell division)
• Inhibit DNA func
• Prevent cell reproduction by altering chemical structure of cell DNA
• Block DNA synthesis

Question 10

Cyclophosphamide (Cytoxan) - Class, AEs, Nursing

Answer 10

• Class: Alkylating Agent
• AEs
  > toxic incr in uric acid lvl
  > CNS toxicity
  > hemorrhagic cystitis
  > general
• Nursing: encourage hydration to prevent cystitis, general

Question 11

Methotrexate (Rheumatrex) - Class, AE, Nursing

Answer 11

• Class: Antimetabolites: Folate Antagonist
• AEs
  > GI ulceration
  > bone marrow suppression
  > general
• Nursing
  > general

Question 12

Doxorubicin (Adriamycin) - Class, AE, nursing

Answer 12

• Class: Antitumor Antibiotics
• AEs
  > injection site extravasation
  > cardiotoxic
  > general
• Nursing
  > general

Question 13

General Antineoplastic AEs

Answer 13

• Hair: alopecia (hair loss)
• Skin: rashes, blisters, photosensivity
• Nervous System: neuropathy/cognitive dysfunc, headache, dizziness
• Cardio/Pulm: toxicity
• Myelosuppression: leukopenia, anemia, thrombocytopenia
• GI: N/V, anorexia, diarrhea/constipation, mucous membrane deterioration (stomatitis)
• Liver/Renal: toxicity
• GU/Reproductive: cystitis, dysfunc

Question 14

Antineoplastic Assessment

Answer 14

• Hx & physical; contraindication; AEs
• Labs: CBC, liver func, kidney func

Question 15

Antineoplastic Nursing Diagnosis

Answer 15

• Fatigue r/t drug effects (anemia) & disease effects
• Disturbed body image r/t alopecia, skin effects
• Risk for infection r/t neutropenia

Question 16

Antineoplastic Expected Outcomes

Answer 16

• Pt will have dcrd cancer growth or spread
• Pt will develop limited AEs
• Pt will understand drug therapy, AEs, & comfort measure to relieve AEs