Chapter 35 : anticancer Drugs

Question 1

What is adjuvant therapy for chemotherapy?

Answer 1

Chemo given after surgical treatment

Question 2

What is neoadjuvant therapy?

Answer 2

Chemo given before surgery to shrink the tumor

Question 3

What is palliative chemotherapy?

Remember they aren’t dying, they just have __( we are treating their ^^!)

Answer 3

Relieves symptoms of advanced disease

Symptoms!!

Question 4

What is the benefits of combination of chemotherapy?

Answer 4

Enhances tumoricidal activity
Increases chance of affecting cancer cells in all phases of cell cycle
Increase synergistic effect to kill cancer cells
Decrease drug resistance

Question 5

What’s the big thing to note about cancer drugs?

Answer 5

Cancer drugs affect both cancer and healthy cells

Question 6

Give me an example of how cancer drugs affect your normal cells?

Answer 6

Skin and hair
GI tract
Mucous membranes
Bone marrow
Reproductive system

Question 7

Notes
Anticancer therapy in outpatients setting

Homes
Oncology clinics
Occupational exposure precuations

Question 8

What is the issue behind chemotherapy?

Answer 8

When the cancer cells don’t divide and instead they go to this resting phase and chemotherapy can kill them

Question 9

As tumor gets bigger, more cells become inactive and convert to G0
Meaning what?

Answer 9

They will not be killed off my chemo therapy

Question 10

What does nadir mean?

Usually when?

Answer 10

The time at which blood counts are the lowest

7-10 days after treatment

Question 11

What does it mean when we have NADIR? (2)

Answer 11

Bleeding
Infection

Question 12

What type of isolation will be put patients in who have nadir?

Answer 12

Neutropenia
( we cover up because we could be sick and get them sick )

No fresh flowers
No visitors

Question 13

What are the methods of administration of chemo?

Answer 13

Oral
IM
Iv

Question 14

How would you give chemo through IV?

And why?

Answer 14

PICC line
Large vein

To avoid extravasation injury
- kills your tissue

Question 15

What are your side effect of chemotherapy? Mainly ones (2)

Answer 15

Myelosuppression
GI disturbances

Question 16

What are the 3 symptoms of myelosuppression?

Answer 16

Anemia - assess fatigue, SOB
Leukopenia - infection risk high
Thrombocytopenia - Petechiae, no clot

Question 17

What are the 3 GI disturbances?

How do you treat each?

Answer 17

Anorexia
- small frequent meals
( protein and calories, carb )

Nausea/vomiting
- provide antiemetics

Diarrhea
- anti-diarrheal

Question 18

When do we give anti-emetics?

Answer 18

30mins before chemo therapy

Then regular Zofran every 4 hours for a day

Question 19

Patients may get something called mucosititis (stomatitis)
Which is?

Treatment?
What’s the downside

Other symptoms
Alopecia- hair loss
Fatigue
Infertility
- pre treatment counseling

Answer 19

Ulcers in the throat or stomach- taste changed, swelling, white coating, dry mouth, redness pain

Usually pain meds or this magic mouthwash before eating it

Downside- numbing so no gag reflex or numbing of the mouth ; injury

Question 20

What is alkalating agents?
- chemo therapy group

What’s important about this?!!

What labs are we doing?

What precautions?

How administrate and what cautions?

Answer 20

Hydrated to avoid hemorrhagic cystitis

CBC, BUN, CR, LFTS

Neutropnia

IV, big veins and no infiltration

Question 21

There are chemo meds that cause cardiotoxicity, so we must monitor patient for?

Answer 21

Cardiac problems
( heart attack, dysthymia )

And put them on telemetry

Question 22

What is the plant alkaloids medication?

What plant is it made of ^

Answer 22

Vincristine

Perrywinkle

Question 23

What are the side effects of plant alkaloids (12)

Answer 23

Loss of deep tendon reflexes
Muscle weakness
Seizures
SOB
neurotoxicity
Visual disturbances
SIADH
Hyponatremia
Hyperuricemia
Paresthesia
Blindness
Difficulty walking

Question 24

What are the side effects of plant alkaloids (12) anagram

Answer 24

Lost
My
secret
Sexy
Neurons
Voguing
Status

Had
Hyper
Pretty
Blindness
Daily

Question 25

So with vincristine, they have muscle weakness and loss of deep tendon reflex’s

What do we tell patients?

And blurred vision can occur
What do we do?

Answer 25

Careful walking because high risk of falling

Baselines of eye exams

Question 26

Nursing responsibilities with
plant alkaloids

Obtain baseline assessment of sensory function

Assess bowel and bladder function

Cardic and respiratory assessment

Monitor for signs of peripheral neuropathy

Administer stool softener encourages patient to increase fluid and fiber

Question 27

She said to note
That’s we can sometimes use hormones to help treat cancer !

Sometimes we use hormones to either suppress a hormone that causes a tumor or we use hormone to help add hormones that a tumor may be forming due to the lack of it

Question 28

What is the one vaccine that prevents cancer?

Answer 28

HPV vaccine

Cervical cancer

Question 29

Practice questions
A patient being treated for cancer is receiving medication for palliaition. Which of the following dose the nurse understand what palliative therapy is used for.

A. Relieve symptoms
B. Kill tumor cells
C. Decrease viral load
D. Increase body defenses

Answer 29

A. Relieve symptoms

Question 30

Practice question 2
A patient is receiving chemotherapy for the treatment of cancer. Of the following choices, which does the nurse anticipates nadir to occur?

A. 2 days
B. 8 days
C. 15 days
D. 30 days

Answer 30

B. 8 days

Question 31

Practice question 3
The nurse assess a patient who is receiving doxorubicin IV. The nurse determines extravasation has occurred. Which of the following is the first action for the nurse to perform?

A. Attempt to aspirate residual doxorubicin from the patients vein

B. Remove the IV catheter

C. Pack the IV site with ice

D. Stop the IV infusion of doxorubicin

Answer 31

D. Stop the IV infusion of doxorubicin