Chapter 35 : anticancer Drugs Flashcards
What is adjuvant therapy for chemotherapy?
Chemo given after surgical treatment
What is neoadjuvant therapy?
Chemo given before surgery to shrink the tumor
What is palliative chemotherapy?
Remember they aren’t dying, they just have __( we are treating their ^^!)
Relieves symptoms of advanced disease
Symptoms!!
What is the benefits of combination of chemotherapy?
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
What’s the big thing to note about cancer drugs?
Cancer drugs affect both cancer and healthy cells
Give me an example of how cancer drugs affect your normal cells?
Skin and hair
GI tract
Mucous membranes
Bone marrow
Reproductive system
Notes
Anticancer therapy in outpatients setting
Homes
Oncology clinics
Occupational exposure precuations
What is the issue behind chemotherapy?
When the cancer cells don’t divide and instead they go to this resting phase and chemotherapy can kill them
As tumor gets bigger, more cells become inactive and convert to G0
Meaning what?
They will not be killed off my chemo therapy
What does nadir mean?
Usually when?
The time at which blood counts are the lowest
7-10 days after treatment
What does it mean when we have NADIR? (2)
Bleeding
Infection
What type of isolation will be put patients in who have nadir?
Neutropenia
( we cover up because we could be sick and get them sick )
No fresh flowers
No visitors
What are the methods of administration of chemo?
Oral
IM
Iv
How would you give chemo through IV?
And why?
PICC line
Large vein
To avoid extravasation injury
- kills your tissue
What are your side effect of chemotherapy? Mainly ones (2)
Myelosuppression
GI disturbances
What are the 3 symptoms of myelosuppression?
Anemia - assess fatigue, SOB
Leukopenia - infection risk high
Thrombocytopenia - Petechiae, no clot
What are the 3 GI disturbances?
How do you treat each?
Anorexia
- small frequent meals
( protein and calories, carb )
Nausea/vomiting
- provide antiemetics
Diarrhea
- anti-diarrheal
When do we give anti-emetics?
30mins before chemo therapy
Then regular Zofran every 4 hours for a day
Patients may get something called mucosititis (stomatitis)
Which is?
Treatment?
What’s the downside
Other symptoms
Alopecia- hair loss
Fatigue
Infertility
- pre treatment counseling
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
What is alkalating agents?
- chemo therapy group
What’s important about this?!!
What labs are we doing?
What precautions?
How administrate and what cautions?
Hydrated to avoid hemorrhagic cystitis
CBC, BUN, CR, LFTS
Neutropnia
IV, big veins and no infiltration
There are chemo meds that cause cardiotoxicity, so we must monitor patient for?
Cardiac problems
( heart attack, dysthymia )
And put them on telemetry
What is the plant alkaloids medication?
What plant is it made of ^
Vincristine
Perrywinkle
What are the side effects of plant alkaloids (12)
Loss of deep tendon reflexes
Muscle weakness
Seizures
SOB
neurotoxicity
Visual disturbances
SIADH
Hyponatremia
Hyperuricemia
Paresthesia
Blindness
Difficulty walking
What are the side effects of plant alkaloids (12) anagram
Lost
My
secret
Sexy
Neurons
Voguing
Status
Had
Hyper
Pretty
Blindness
Daily
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?
Careful walking because high risk of falling
Baselines of eye exams
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
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
What is the one vaccine that prevents cancer?
HPV vaccine
Cervical cancer
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
A. Relieve symptoms
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
B. 8 days
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
D. Stop the IV infusion of doxorubicin
