exam 3: oncology

Question 1

alkylating agents

Answer 1

damage the cell’s DNA, causing the DNA strand to break

Question 2

alkylating agents prevent. . .

Answer 2

the reproduction of cancer cells

Question 3

nitrogen mustards

Answer 3

same as alkylating agents

Question 4

antitumor antibiotics

Answer 4

interfere with DNA replication and RNA transcription

Question 5

antitumor antibiotics do not treat. . .

Answer 5

infection

Question 6

plant alkaloid causes. . .

Answer 6

cell dysfunction during mitosis

Question 7

cyclophosphamide treats. . .

Answer 7

• non-hodgkins/hodgkins lymphoma
• CLL
• multiple myeloma
• breast, ovarian, lung cancer

Question 8

common s/e of cyclophosphamide

Answer 8

• alopecia
• fever
• neutropenia
• anemia
• thrombocytopenia

Question 9

major s/e of cyclophosphamide

Answer 9

• bone marrow suppression
• hemorrhagic cystitis
• TLS (tumor lysis syndrome)

Question 10

cyclophosphamide is contraindicated in clients who have an obstructed. . .

Answer 10

urinary outflow

Question 11

labs to monitor with cyclophosphamide

Answer 11

• CBC
• platelets
• urine

Question 12

what may be used to prevent bladder toxicity with cyclophosphamide

Answer 12

mesna

Question 13

pt education for cyclophosphamide

Answer 13

• increase fluid intake
• report urinary s/s
• choose an effective birth control method
• report s/s of infection

Question 14

doxorubicin is used to treat. . .

Answer 14

• breast cancer with lymph node involvement
• ALL
• AML
• Hodgkin/Non-Hodgkin Lymphoma

Question 15

doxorubicin interferes with ________ by ______

Answer 15

cell cycle division by binding to DNA

Question 16

doxorubicin is also known as the. . .

Answer 16

red devil

Question 17

common s/e of doxorubicin

Answer 17

• alopecia
• fatigue
• mucositis
• dry skin
• anorexia

Question 18

major s/e of doxorubicin

Answer 18

• cardiac toxicity
• bone marrow suppression

Question 19

doxorubicin is contraindicated in pts with. . .

Answer 19

• severe myocardial insufficiency
• recent MI (last 4-6wks)
• severe myelosuppression
• severe hepatic impairment

Question 20

what should the nurse monitor before each dose of doxorubicin?

Answer 20

• ECG
• CXR
• echocardiogram
• left ventricular EF

Question 21

what should the pt report while taking doxorubicin?

Answer 21

• any s/s of infection, tachycardia, cough, SOB, lower extremity edema
• any s/s of redness, burning or blisters on palms of hands/soles of feet

Question 22

urine appearance during doxorubicin therapy

Answer 22

red

Question 23

labs to monitor with doxorubicin administration

Answer 23

• CBC
• platelets, uric acid
• electrolytes
• liver + kidney function

Question 24

nurse should assess and monitor for _____ when giving doxorubicin

Answer 24

• bone marrow suppression (thrombocytopenia, neutropenia, anemia)
• cardiac status
• Tumor Lysis Syndrome

Question 25

common s/e with methotrexate

Answer 25

- ulcerative stomatitis - leukopenia - malaise

Question 26

major s/e with methotrexate

Answer 26

- TLS - toxicity (GI, pulmonary, hepatic)

Question 27

methotrexate shouldn't be given to. . .

Answer 27

- pregnant females with psoriasis/RA - breastfeeding

Question 28

what should the pt avoid when taking methotrexate

Answer 28

- pregnancy/effective contraceptive 3 months after treatment - alcohol

Question 29

labs and illnesses to monitor for when administering methotrexate

Answer 29

- CBC - platelets - renal/liver function tests - leukopenia - thrombocytopenia - serum methotrexate levels - TLS

Question 30

vincristine is used when treating. . .

Answer 30

- ALL - Hodgkin/Non-Hodgkin Lymphoma - neuroblastoma - Wilms tumor

Question 31

vincristine is cell cycle specific on the _____ phase by inhibiting ______

Answer 31

- M phase - mitosis

Question 32

common s/e with vincristine

Answer 32

- cranial nerve damage - dysuria - HTN - hypotension

Question 33

major s/e with vincristine

Answer 33

- extravasation (antidote is Hyaluronidase - SIADH (body produces too much ADH)

Question 34

when would vincristine result in fatality?

Answer 34

if given any other route than IV

Question 35

labs to monitor with vincristine

Answer 35

- bilirubin - kidney function *neutropenia, thrombocytopenia, hyponatremia*

Question 36

what should the nurse determine prior to vincristine administration?

Answer 36

absolute patency of vein and adequate circulation of extremity

Question 37

the nurse should monitor what status and WHY during vincristine therapy?

Answer 37

neuro status d/t neurotoxicity being prevalent in the elderly

Question 38

pt education for vincristine (things to avoid, reports, etc)

Answer 38

- avoid pregnancy and/or d/c breastfeeding - report burning/stinging at IV site - increase fluid

Question 39

types of cancers that tamoxifen treats

Answer 39

- breast (male & female) - ovarian - uterine - testicular - prostate

Question 40

tamoxifen blocks the stimulation of growing cells specific to what hormone?

Answer 40

estrogen

Question 41

tamoxifen increases the risk for. . .

Answer 41

- uterine cancer - thrombosis - CV disease

Question 42

common s/e of tamoxifen

Answer 42

- missed periods - bladder pain - pyuria (pus in urine) - weight gain - photosensitivity

Question 43

major s/e of tamoxifen

Answer 43

- GI toxicity - hypercalcemia

Question 44

pt education for tamoxifen

Answer 44

- adequate oral hygiene - protect skin from UV - weigh weekly - utilize contraception - small, frequent meals - increase fluids to 2L/day

Question 45

labs to monitor with tamoxifen

Answer 45

- calcium - renal/liver function - cholesterol - triglycerides

Question 46

the nurse should monitor for ____ when administering tamoxifen

Answer 46

s/s of DVT, PE, stroke (edema, SOB, pain)