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z_MS_Primers for Exam 4 > Chemotherapy > Flashcards

Chemotherapy Flashcards

1
Q

What is the goal of Chemotherapy?

A

to eliminate or reduce the number of malignant cells

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2
Q

What are the factors involved in determining response to treatment?

A
  • Rapid mitotic rate
  • Size of tumor
  • Age of tumor
  • Location of tumor
  • Presence of resistant tumor cells
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3
Q

What is the effect of chemotherapy against cells?

A

It stops the replication of cancer cells by arresting them in the G0 phase

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4
Q

What protective measures must be taken when handling chemotherapy drugs and why?

A
  • Wear gloves and mask when handling drugs
  • Drugs may be absorbed through skin or inhaled
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5
Q

What are the four stages of chemotherapy?

A
  • Induction
  • Intensification
  • Consolidation
  • Maintenance
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6
Q

Describe the induction stage of chemotherapy.

A
  • Large amounts of therapy given in an attempt to induce remission.
  • Seek to destroy leukemic cells in tissues, peripheral blood, and bone marrow.
  • Patient may become critically ill.
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7
Q

During the induction phase, nursing interventions focus on…

A
  • Neutropenia, thrombocytopenia, and anemia
  • Psychological support for the patient and family
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8
Q

After one course of induction therapy, approximately __% of newly diagnosed patients achieve complete remission.

A

• 70%

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9
Q

Describe the intensification stage of chemotherapy.

A
  • High-dose therapy to kill any remaining cancer cells post induction therapy
  • Same drugs at higher doses and/or other drugs
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10
Q

Describe the consolidation stage of chemotherapy.

A
  • Given after remission is achieved to eliminate remaining leukemic cells that may not be pathologically evident
  • Same drugs at higher doses and/or other drugs
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11
Q

Describe the maintenance stage of chemotherapy.

A
  • Lower doses of the same drug given every 3 to 4 weeks
  • Goal is to keep the body free of leukemic cells.
  • In AML, maintenance therapy is rarely effective and therefore is rarely administered.
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12
Q

What is the point of combination chemotherapy?

A
  • ↓ Drug resistance
  • ↓ Drug toxicity using multiple drugs
  • Interrupt cell growth at multiple points
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13
Q

Drugs may be irritants or vesicants. Describe the difference.

A
  • Irritants: Damage intima of vein, but not tissue
  • Vesicants: Severe local tissue breakdown and necrosis
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14
Q

What are some s/s of extravasation?

A

Redness or swelling w/ cool pale skin surrounding the IV site

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15
Q

If extravasation is suspected, what action should be taken?

A
  • STOP infusion: aspirate rest of drug
  • Leave needle in place: so can infuse antidote
  • No pressure-sterile occlusive dressing, elevate, heat or cold (according to guidelines)
  • Document: photo if guidelines specify; monitor
  • Patient teaching-site care
  • Plastic Surgery prn
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16
Q

What should the patient report when receiving vesicant drugs?

A

Sensations of burning or pan at infusion site

17
Q

What are the methods of administration for chemotherapy?

A
  • Central line
  • Directly into tumor
  • Intra-arterial
  • Intra-vesical bladder
  • Intrathecal/intraventricular
18
Q

What are the advantages of central line chemotherapy?

A
  • Placement in large blood vessels (safety)
  • Frequent, continuous, or intermittent administration
  • Can be used to administer other fluids (blood, electrolytes, etc.)
19
Q

What is the advantage of delivering chemotherapy directly into tumor site?

A

Higher concentrations of drug can be delivered with less systemic toxicity.

20
Q

Describe intra-arterial administration of chemotherapy.

A

Delivers drug through arterial vessel supplying tumor

21
Q

Describe intra-peritoneal administration of chemotherapy.

A

Delivers drug to peritoneal cavity for treatment of peritoneal metastases

22
Q

How is intra-peritoneal chemotherapy delivered?

A
  • Chemotherapy is generally infused into the peritoneum in 1 to 2 L of fluid
  • Allowed to “dwell” in the peritoneum for a period of 1 to 4 hours.
  • Following the “dwell time,” the fluid is drained from the peritoneum.
23
Q

Describe Intrathecal or intraventricular chemotherapy administration and what cancers it is commonly used for.

A
  • Involves lumbar puncture and injection of chemotherapy into subarachnoid space
  • Commonly used for breast, lung, and GI tumors, leukemia, and lymphoma.
24
Q

Describe intra-vesical bladder administration of chemotherapy.

A

Agent added to bladder by urinary catheter and retained for 1 to 3 hours

25
Q

What are the complications of intra-vesical bladder chemotherapy?

A
  • Dysuria
  • Urinary frequency
  • Hematuria
  • Cystitis
  • Urinary tract infection
  • Bladder spasms.
26
Q

What are the two types of venous access devices used for systemic delivery of chemotherapy?

A
  • Non-tunneled PICC line
  • Tunneled central venous line
27
Q

True or False

The use of PICC and Central lines is a clean procedure and are flushed with procedure with LR solution.

A

False. It is a STERILE procedure and they are flushed w/ NS

28
Q

True or False

Chemotherapeutic agents cannot distinguish between normal and cancer cells

A

True

29
Q

What are 3 common body responses to products of cellular destruction

A
  • Fatigue
  • Anorexia
  • Taste alterations
30
Q

What are the 3 classes of general and drug-specific adverse effects of chemotherapy?

A
  • Acute
  • Delayed
  • Chronic
31
Q

Describe acute toxicity to chemotherapy.

A

Occurs during and immediately after drug administration and includes:

  • Anaphylactic and hypersensitivity reactions
  • Extravasation or a flare reaction
  • Anticipatory nausea and vomiting, and cardiac dysrhythmias.
32
Q

Delayed effects to chemotherapy are numerous and include:

A
  • Delayed N/V
  • Mucositis
  • Alopecia
  • Skin rashes
  • Bone marrow suppression, and
  • Altered bowel function (diarrhea or constipation)
33
Q

Chronic toxicities of chemotherapy involve damage to

A

organs such as the heart, liver, kidneys, and lungs.

34
Q

True or False

Chemotherapy drugs are given one after another

A

False, they are given in combination

35
Q

Chemotherapy dosages are carefully calculated according to

A

Chemotherapy dosages are carefully calculated according to

BSA

36
Q

Selecting chemotherapy drugs with different modes of action minimizes

A

occurrence and severity of adverse effects

z_MS_Primers for Exam 4 (18 decks)

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