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Cellular Regulation Exam > Chemotherapy, Biotherapy, Symptom Mgmt and Oncologic Emergencies > Flashcards

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
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2
Q

hematological alterations that CA has on the body

A

decreased leukocytes, erythrocytes, thrombocytes

altered erythropoiesis

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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

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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
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5
Q

role of antitumor antibiotic

A

damage DNA synthesis, alter cell’s ability to divide

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6
Q

role of alkylating agents

A

bind DNA tightly and impair cell division

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7
Q

are akylating agents cell cycle specific

A

NO

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8
Q

role of mitotic inhibitors

A

prevent cell from completing mitosis

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9
Q

are mitotic inhibitors cell cycle specific

A

YES

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10
Q

role of hormonal agents

A

not considered true chemo, work on hormone alteration

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11
Q

antitumor antibiotics end in what

A

-mycin

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12
Q

are antitumor antibiotics cell cycle specific

A

NO

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13
Q

T or F: antitumor antibiotics can cause severe muscle/tissue damage

A

TRUE

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14
Q

type of cells that chemo agents kill

A

ALL cells

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15
Q

which cells are the most effected by chemo agents

A

rapidly dividing cells

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16
Q

examples of rapidly dividing cells

A

hair, skin, intestinal tract, sperm, blood forming cells

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17
Q

nadir

A

when pts counts drop at a certain point in the chemo cycle due to effects of chemo agent

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18
Q

CA pts receiving chemo are prone to what

A

infection and bleeding

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19
Q

effects of bone marrow suppression

A

anemia
infection
bleeding

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20
Q

most common SE of chemo

A 
anemia (fatigue)
neutropenia (infection)
thrombocytopenia (bleeding)
alopecia
mucositis
n/v
sleep disturbance
changes in cognition
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21
Q

number 1 dose limiting SE and cause of death with chemo

A

neutropenia

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22
Q

cause of neutropenia

A

overgrowth of normal flora

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23
Q

important nursing actions for neutropenia

A

assess mouth, lungs, IV site, temperature

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24
Q

this is considered an emergency in a neutropenic pt

A

temp elevation

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25
Q

T or F: one nurse can administer chemo

A

FALSE, must be 2

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26
Q

an issue that may occur when giving chemo via an IV

A

extravasation

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27
Q

what vein does a picc line go in

A

SVC

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28
Q

first thing to do if extravasation is expected

A

stop infusion

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29
Q

how to tell if an artery has been punctured instead of a vein

A

blood going up tubing, pulsating

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30
Q

drugs that counteract major SE of other drugs and save pts from dying

A

cytoprotective agents

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31
Q

teaching for patients taking cyclophsphamide/ifosphamide

A

s/s of hematuria and hemorrhagic cystitis
empty bladder every 2-3 hrs
hydrate 2-3 L per day

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32
Q

major SE of cyclophsphamide/ifosphamide

A

hemorrhagic cystitis

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33
Q

when taking cyclophsphamide/ifosphamide what may be a major lifestyle change

A

drinking 2-3 L of fluid per day

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34
Q

drug class for cyclophsphamide/ifosphamide

A

alkylating agent

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35
Q

tell pts taking cyclophsphamide/ifosphamide to call dr immediately if what occurs

A

hematuria

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36
Q

cytoprotective drug for pts taking cyclophsphamide/ifosphamide

A

mesna

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37
Q

what is mesna

A

rescue agent given to prevent/treat hemorrhagic cystitis

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38
Q

why do we hydrate pts taking cyclophsphamide/ifosphamide prior to chemo

A

haven’t had fluids all night and fluids are essential

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39
Q

major SE of 5 FU (F-GI)

A

GI issues

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40
Q

drug class of 5 FU (F-GI)

A

antimetabolite

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41
Q

pts taking 5 FU (F-GI) should be pre-medicated with what

A

antiemetic

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42
Q

drug class of doxorubicin (adriamycin)

A

antitumor antibiotic

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43
Q

major SE of doxorubicin (adriamycin)

A

cardiotoxic

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44
Q

cytoprotective agent for doxorubicin (adriamycin)

A

zinecard

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45
Q

when giving this drug pts should have a baseline EKG

A

doxorubicin (adriamycin)

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46
Q

zinecard is the cytoprotective agent for which drug

A

doxorubicin (adriamycin)

47
Q

drug class of bleomycin

A

antitumor antibiotic

48
Q

major SE of bleomycin

A

pneumonitis and pulmonary fibrosis

49
Q

what does it mean if a pt taking bleomycin coughs

A

could indicate anaplylaxis

50
Q

chance of anaphylaxis when taking this drug

A

bleomycin

51
Q

drug class of vincristine (oncovin)

A

alkylating agent

52
Q

major SE of vincristine (oncovin)

A

peripheral neuropathy

53
Q

drug that has a major SE of peripheral neuropathy

A

vincristine (oncovin)

54
Q

drug class of methotrexate

A

antimetabolite

55
Q

cytoprotective drug given with methotrexate

A

leukovorin

56
Q

purpose of giving leukovorin

A

restores folic acid into the system

57
Q

leukovorin is the cytoprotective agent for which drug

A

methotrexate

58
Q

reason for giving zinecard

A

rescue agent used to prevent cardiotoxicity

59
Q

high doses of methotrexate may cause what

A

hypotension

60
Q

drug class of cisplatin (platinol)

A

alkylating agent

61
Q

major SE of cisplatin (platinol)

A

renal damage

deafness

62
Q

which drug may cause renal damage and/or deafness

A

cisplatin (platinol)

63
Q

SE of corticosteroids

A 
infection
edema
altered electrolytes
increased blood sugar
bleeding
64
Q

commonly used sex hormone

A

tamoxifen

65
Q

SE of tamoxifen

A

hot flashes
HA
fatigue
nausea

66
Q

SE of lupron for men

A

gynecomastia and libido loss

67
Q

tamoxifen and lupron are what type of drug

A

hormones

68
Q

a serious, deadly complication in oncology

A

sepsis

69
Q

biotherapy

A

modify biologic responses to tumor cells and enhance the immune system

70
Q

hormones made by WBCs

A

cytokines

71
Q

charge up immune system and enhance attacks on CA cells

A

interleukin

72
Q

slow tumor cell division (biotherapy)

A

interferon

73
Q

types of biotherapy

A

cytokines
interleukin
interferon
hematopoietic growth factor

74
Q

drugs given to improve hgb and hct

A

epoetin alpha/procrit

75
Q

SE of procrit

A

HTN
HA
pain at injection site

76
Q

drugs given to improve WBC

A

filgrastim or neupogen

77
Q

SE of neupogen

A

bone pain

78
Q

drugs given to improve platelets

A

oprelvekin or neumega

79
Q

platelets under what level put you at risk for spontaneous bleeding

A

25,000

80
Q

ANC less than what poses a great risk of infection

A

1,000

81
Q

T or F: too much fluid can cause a decrease hgb/hct

A

TRUE, can dilute blood

82
Q

examples of meds in targeted therapy group

A

herceptin
rituxan
gleevac

83
Q

major SE of herceptin

A

cardiac

84
Q

lab level that is a good way to tell how nourished a pt is

A

albumin

85
Q

normal albumin level

A

3.5-5.5

86
Q

examples of serotonin agonists to reduce n/v

A

zofran
anzamet
kytril

87
Q

SE of serotonin agonists

A

vertigo
hypotension
bradycardia
HA

88
Q

important to do when pt is fatigued

A

assess cause of fatigue

89
Q

commonly used pain med in CA

A

morphine

90
Q

med used to treat bone pain

A

NSAIDs

91
Q

med used to treat nerve pain

A

neurontin

92
Q

SE of echinasea (CAM)

A

hepatotoxicity

93
Q

SE of ginko (CAM)

A

inhibits blood clotting

94
Q

SE of saw palmetto (CAM)

A

increases effects of estrogen hormones

95
Q

SE of st john’s wort (CAM)

A

increase photosensitivity and interfere with antineoplastics

96
Q

SE of co q10 (CAM)

A

alters o2 in tissues and decreases effectiveness of radiation therapy

97
Q

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

A

TLS

98
Q

s/s of TLS

A 
cardiac dysrhythmias
hyperkalemia
hyperphosphatemia
hypocalcemia
azotemia
N/V/D
muscle cramps
oliguria
99
Q

oncologic emergency in which more calcium is relased from the bones than the kidneys can excrete or bones can reabsorb

A

hypercalcemia

100
Q

s/s of hypercalcemia

A 
N/V
constipation
polyuria
polydipsia
weakness
bone pain
kidney stones
confusion
altered LOC
dehydration
dysrhythmias
101
Q

tx of TLS

A

IV fluids 150-200 ml/hr
loop diuretic
add bicarb to fluids
allopurinol

102
Q

tx of hypercalcemia

A

0.9 NS
lasix
IV bisphosphonate

103
Q

why is bisphosphonate given in hypercalcemia

A

to inhibit bone resorption

104
Q

oncologic emergecny in which there is an excessive release of ADH and the kidneys absorb free water

A

SIADH

105
Q

s/s of SIADH

A 
anorexia
fatigue
HA
muscle cramps
confusion
N/V
constipation
oliguria
106
Q

tx/assessments of SIADH

A

restric fluid intake to 1 L per day
implement seizure precautions
neuro checks
monitor I&O

107
Q

oncologic emergency in which a tumor suppresses a portion of the spinal cord

A

spinal cord compression

108
Q

hallmark sign of spinal cord compression

A

new onset back pain

109
Q

s/s of spinal cord compression

A 
back pain that worsens with movement
local inflammation
venous stasis
numbness
tingling
loss of reflexes
loss of B/B fxn
110
Q

tx of spinal cord compression

A

radiation

surgery

111
Q

oncologic emergency in which venous flow thru the SVC is obstructed causing impaired venous circulation/drainage

A

SVC syndrome

112
Q

s/s of SVC syndrome

A 
dyspnea
non-productive cough
hoarseness
dysphagia
facial swelling
edema of head, neck, arms, hands
increased ICP
113
Q

tx of SVC syndrome

A

radiation
corticosteroids
IV stent in some cases

Cellular Regulation Exam (4 decks)

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