Chemotherapy, Biotherapy, Symptom Mgmt and Oncologic Emergencies Flashcards
1
Q
factors that may alter or weaken immune system
A
stress depression increased age pregnancy chronic disease chemo
2
Q
hematological alterations that CA has on the body
A
decreased leukocytes, erythrocytes, thrombocytes
altered erythropoiesis
3
Q
why do chemo agents work to act on the S phase and M phase of cells
A
this is where the cell is most vulnerable
4
Q
role of antimetabolite
A
fool cells into using antimetabolites in cellular rxn
- impairs cell division
- works best on rapidly dividing cells and tumors
5
Q
role of antitumor antibiotic
A
damage DNA synthesis, alter cell’s ability to divide
6
Q
role of alkylating agents
A
bind DNA tightly and impair cell division
7
Q
are akylating agents cell cycle specific
A
NO
8
Q
role of mitotic inhibitors
A
prevent cell from completing mitosis
9
Q
are mitotic inhibitors cell cycle specific
A
YES
10
Q
role of hormonal agents
A
not considered true chemo, work on hormone alteration
11
Q
antitumor antibiotics end in what
A
-mycin
12
Q
are antitumor antibiotics cell cycle specific
A
NO
13
Q
T or F: antitumor antibiotics can cause severe muscle/tissue damage
A
TRUE
14
Q
type of cells that chemo agents kill
A
ALL cells
15
Q
which cells are the most effected by chemo agents
A
rapidly dividing cells
16
Q
examples of rapidly dividing cells
A
hair, skin, intestinal tract, sperm, blood forming cells
17
Q
nadir
A
when pts counts drop at a certain point in the chemo cycle due to effects of chemo agent
18
Q
CA pts receiving chemo are prone to what
A
infection and bleeding
19
Q
effects of bone marrow suppression
A
anemia
infection
bleeding
20
Q
most common SE of chemo
A
anemia (fatigue) neutropenia (infection) thrombocytopenia (bleeding) alopecia mucositis n/v sleep disturbance changes in cognition
21
Q
number 1 dose limiting SE and cause of death with chemo
A
neutropenia
22
Q
cause of neutropenia
A
overgrowth of normal flora
23
Q
important nursing actions for neutropenia
A
assess mouth, lungs, IV site, temperature
24
Q
this is considered an emergency in a neutropenic pt
A
temp elevation
25
T or F: one nurse can administer chemo
FALSE, must be 2
26
an issue that may occur when giving chemo via an IV
extravasation
27
what vein does a picc line go in
SVC
28
first thing to do if extravasation is expected
stop infusion
29
how to tell if an artery has been punctured instead of a vein
blood going up tubing, pulsating
30
drugs that counteract major SE of other drugs and save pts from dying
cytoprotective agents
31
teaching for patients taking cyclophsphamide/ifosphamide
s/s of hematuria and hemorrhagic cystitis
empty bladder every 2-3 hrs
hydrate 2-3 L per day
32
major SE of cyclophsphamide/ifosphamide
hemorrhagic cystitis
33
when taking cyclophsphamide/ifosphamide what may be a major lifestyle change
drinking 2-3 L of fluid per day
34
drug class for cyclophsphamide/ifosphamide
alkylating agent
35
tell pts taking cyclophsphamide/ifosphamide to call dr immediately if what occurs
hematuria
36
cytoprotective drug for pts taking cyclophsphamide/ifosphamide
mesna
37
what is mesna
rescue agent given to prevent/treat hemorrhagic cystitis
38
why do we hydrate pts taking cyclophsphamide/ifosphamide prior to chemo
haven't had fluids all night and fluids are essential
39
major SE of 5 FU (F-GI)
GI issues
40
drug class of 5 FU (F-GI)
antimetabolite
41
pts taking 5 FU (F-GI) should be pre-medicated with what
antiemetic
42
drug class of doxorubicin (adriamycin)
antitumor antibiotic
43
major SE of doxorubicin (adriamycin)
cardiotoxic
44
cytoprotective agent for doxorubicin (adriamycin)
zinecard
45
when giving this drug pts should have a baseline EKG
doxorubicin (adriamycin)
46
zinecard is the cytoprotective agent for which drug
doxorubicin (adriamycin)
47
drug class of bleomycin
antitumor antibiotic
48
major SE of bleomycin
pneumonitis and pulmonary fibrosis
49
what does it mean if a pt taking bleomycin coughs
could indicate anaplylaxis
50
chance of anaphylaxis when taking this drug
bleomycin
51
drug class of vincristine (oncovin)
alkylating agent
52
major SE of vincristine (oncovin)
peripheral neuropathy
53
drug that has a major SE of peripheral neuropathy
vincristine (oncovin)
54
drug class of methotrexate
antimetabolite
55
cytoprotective drug given with methotrexate
leukovorin
56
purpose of giving leukovorin
restores folic acid into the system
57
leukovorin is the cytoprotective agent for which drug
methotrexate
58
reason for giving zinecard
rescue agent used to prevent cardiotoxicity
59
high doses of methotrexate may cause what
hypotension
60
drug class of cisplatin (platinol)
alkylating agent
61
major SE of cisplatin (platinol)
renal damage
| deafness
62
which drug may cause renal damage and/or deafness
cisplatin (platinol)
63
SE of corticosteroids
```
infection
edema
altered electrolytes
increased blood sugar
bleeding
```
64
commonly used sex hormone
tamoxifen
65
SE of tamoxifen
hot flashes
HA
fatigue
nausea
66
SE of lupron for men
gynecomastia and libido loss
67
tamoxifen and lupron are what type of drug
hormones
68
a serious, deadly complication in oncology
sepsis
69
biotherapy
modify biologic responses to tumor cells and enhance the immune system
70
hormones made by WBCs
cytokines
71
charge up immune system and enhance attacks on CA cells
interleukin
72
slow tumor cell division (biotherapy)
interferon
73
types of biotherapy
cytokines
interleukin
interferon
hematopoietic growth factor
74
drugs given to improve hgb and hct
epoetin alpha/procrit
75
SE of procrit
HTN
HA
pain at injection site
76
drugs given to improve WBC
filgrastim or neupogen
77
SE of neupogen
bone pain
78
drugs given to improve platelets
oprelvekin or neumega
79
platelets under what level put you at risk for spontaneous bleeding
25,000
80
ANC less than what poses a great risk of infection
1,000
81
T or F: too much fluid can cause a decrease hgb/hct
TRUE, can dilute blood
82
examples of meds in targeted therapy group
herceptin
rituxan
gleevac
83
major SE of herceptin
cardiac
84
lab level that is a good way to tell how nourished a pt is
albumin
85
normal albumin level
3.5-5.5
86
examples of serotonin agonists to reduce n/v
zofran
anzamet
kytril
87
SE of serotonin agonists
vertigo
hypotension
bradycardia
HA
88
important to do when pt is fatigued
assess cause of fatigue
89
commonly used pain med in CA
morphine
90
med used to treat bone pain
NSAIDs
91
med used to treat nerve pain
neurontin
92
SE of echinasea (CAM)
hepatotoxicity
93
SE of ginko (CAM)
inhibits blood clotting
94
SE of saw palmetto (CAM)
increases effects of estrogen hormones
95
SE of st john's wort (CAM)
increase photosensitivity and interfere with antineoplastics
96
SE of co q10 (CAM)
alters o2 in tissues and decreases effectiveness of radiation therapy
97
oncologic emergency in which dying cancer cells release large amounts of potassium, phosphorus, and nucleic acid into the bloodstream and the kidneys can't filter it
TLS
98
s/s of TLS
```
cardiac dysrhythmias
hyperkalemia
hyperphosphatemia
hypocalcemia
azotemia
N/V/D
muscle cramps
oliguria
```
99
oncologic emergency in which more calcium is relased from the bones than the kidneys can excrete or bones can reabsorb
hypercalcemia
100
s/s of hypercalcemia
```
N/V
constipation
polyuria
polydipsia
weakness
bone pain
kidney stones
confusion
altered LOC
dehydration
dysrhythmias
```
101
tx of TLS
IV fluids 150-200 ml/hr
loop diuretic
add bicarb to fluids
allopurinol
102
tx of hypercalcemia
0.9 NS
lasix
IV bisphosphonate
103
why is bisphosphonate given in hypercalcemia
to inhibit bone resorption
104
oncologic emergecny in which there is an excessive release of ADH and the kidneys absorb free water
SIADH
105
s/s of SIADH
```
anorexia
fatigue
HA
muscle cramps
confusion
N/V
constipation
oliguria
```
106
tx/assessments of SIADH
restric fluid intake to 1 L per day
implement seizure precautions
neuro checks
monitor I&O
107
oncologic emergency in which a tumor suppresses a portion of the spinal cord
spinal cord compression
108
hallmark sign of spinal cord compression
new onset back pain
109
s/s of spinal cord compression
```
back pain that worsens with movement
local inflammation
venous stasis
numbness
tingling
loss of reflexes
loss of B/B fxn
```
110
tx of spinal cord compression
radiation
| surgery
111
oncologic emergency in which venous flow thru the SVC is obstructed causing impaired venous circulation/drainage
SVC syndrome
112
s/s of SVC syndrome
```
dyspnea
non-productive cough
hoarseness
dysphagia
facial swelling
edema of head, neck, arms, hands
increased ICP
```
113
tx of SVC syndrome
radiation
corticosteroids
IV stent in some cases
