FTY Learning

Question 1

Cyclizine is to be given by subcutaneous infusion over 24 hours to a palliative patient. The nurse is unsure what diluent should be used. What would you reccomend and why?

Answer 1

Cyclizine is INcompatiable with NaCl and therefore this should not be used.

WFI would be suitable.

Question 2

Bone Marrow Supression is caused by all cytotoxic drugs EXCEPT which 2 drugs?

Answer 2

Bone marrow suppression (caused by all cytoxics
except vincristine and bleomycin)

Question 3

1. Are most drugs adminstered via CSCI acidic or alkaline?
2. Name one drug which is the opposite of the answer above.
3. What usually needs to be done when administering this drug?

Thinking in terms of continuous subcutaneous infusions.

Answer 3

1. Most of the medicines used by subcutaneous infusion are acidic
2. A few are alkaline (e.g. diclofenac)
3. and therefore usually need to be given via a separate infusion

Question 4

What is the maximum volume that can be administered for a subcutaneous bolus?

Answer 4

2mL

Question 5

True or False

For continuous subcutaneous infusions, the cannula needs to be flused prior to administering medicines and after with WFI and also between any incompatiable medicines?

Answer 5

It is true that the line should be flushed after medicines and between incompatiable medicines.

However - lines do not need to be flushed before administeration. The exception to this is for haloperidol and cylizine

Question 6

Do bisphosphonates cause hypo or hypercalcaemia?

Answer 6

Hypo

Question 7

What are MHRA warnings/side-effects regarding bisphosphonate usage?

Answer 7

Atypical femoral fractures
Patients should be advised to report any thigh, hip, or groin pain during treatment with a bisphosphonate.

Osteonecrosis of the jaw
During bisphosphonate treatment patients should maintain good oral hygiene, receive routine dental check-ups, and report any oral symptoms.

Osteonecrosis of the external auditory canal
Patients should be advised to report any ear pain, discharge from ear or an ear infection during treatment with a bisphosphonate.

Patient and carer advice For zoledronic acid
A patient reminder card should be provided (risk of osteonecrosis of the jaw).

Question 8

What is osteonecrosis?

Answer 8

In osteonecrosis, blood flow to part of a bone is disrupted. This results in death of bone tissue, and the bone can eventually break down and the joint will collapse. Osteonecrosis is also called: Avascular necrosis.

Question 9

What can be used for neuropathic pain due to nerve compression

Answer 9

Dexamethasone

Question 10

Continuous glucose monitoring should be offered to type 1 Diabetes patients. Capilary blood glucose levels are still required but less frequently. If CGM unsuited or not tolerated then patients should measure their capilariy blood glucose levels how often?

What are the target BMs at different points throughout the day?

Answer 10

at least four times a day, including before each meal and before bed. Patients should aim for:

a fasting blood-glucose concentration of 5–7 mmol/litre on waking

a blood-glucose concentration of 4–7 mmol/litre before meals at other times of the day;

a blood-glucose concentration of 5–9 mmol/litre at least 90 minutes after eating;

a blood-glucose concentration of at least 5 mmol/litre when driving, as recommended by the Driver and Vehicle Licensing Agency (DVLA).