Managing Side Effects

Question 1

How do you manage constipation?

Answer 1

• Drink 2L of fluids daily unless contraindicated
• Encourage activity
• Increase amount of fresh fruits/veggies daily
• Use whole grain products
• Assess for BM daily
• Request order for stool softness or laxatives

Question 2

How do you manage dry mouth?

Answer 2

• Assess integrity of mm with each shift assessment
• ice chips
• lemon ice or lemon juice to increase salivation
• rinse mouth with non-astringent mouth wash
• suck on sugar free chad or chew sugar free gum
• request saliva substitute

Question 3

How do you manage thrust or candidiasis from ATB?

Answer 3

• assess integrity of mm with each shift assessment
• request yogurt with active cultures daily
• request order for lactobacillus or sacchromyces bullardi to maintain normal flora
• request mycostatin swish and swallow for client, paint on with oral swab if client cannot swish and swallow
• discourage intake of acid-containing foods and fluids

Question 4

How do you manage intertrgio (candidiasis under the skin folds)?

Answer 4

• Assess under skin folds
• keep areas clean and dry
• request order for mycostatin powder, apply sparingly
• request the wound care nurse to see client if problem is not resolving
• request wicking material such as interdry AG

Question 5

How do you manage orthostatic hypotension?

Answer 5

• know which medications this may occur with
• assess for orthostatic changes when cardiovascular meds are initiated
• have client sit on edge of bed for at least 2 minutes before rising
• rise slowly
• teach client to avoid standing for long periods of time
• no long, hot showers
• inform PCP if this occurs
• may order TED hose

Question 6

How do you manage nausea?

Answer 6

• take meds with nonirritating foods or beverages
• in case of opiates, request antiemetic and premeditate
• have client sip on cola or ginger ale
• keep the room smelling fresh, remove old food trays, dead flowers, etc

Question 7

How do you manage gingival hyperplasia?

Answer 7

• teach client about need for semi-annual dental exams
• teach gentle brushing and flossing twice a day at minimum
• report any dental pain or dental mobility

Question 8

How do you manage bleeding?

Answer 8

• wear medic alert tag
• care is to be taken when performing chores in the home/work
• no throw rugs or bath oils, always wear shoes
• go for all lab appointments
• no hard bristle tooth brush or vigorous flossing
• hold venipuncture sites for a longer period of time

Question 9

How do you manage leukopenia?

Answer 9

• no fresh fruits/veggies
• no plants or fresh flowers in room
• no ill nurses/visitors

Question 10

How do you manage thrombocytopenia?

Answer 10

• limit blood draws and IM injections?
• limit use of auto cuff BP and freq of VS
• monitor for occult bleeding
• soft tooth brush

Question 11

How do you manage edema?

Answer 11

• decrease sodium in diet
• elevate extremities, avoid prolonged positions in one place
• may need compression hose or jobst garments
• increase fluid intake if not contraindicated

Question 12

How do you manage dry skin?

Answer 12

• use emollient creams that do not contain alcohol
• avoid use of harsh soaps
• increase fluid intake
• limit bathing

Question 13

How do you manage drowsiness?

Answer 13

• do not take with alcohol or other meds
• do not drive or operate heavy of dangerous machinery until effects of med is known
• check with PCP to determine if medication can be stopped abruptly or needs to be tapered over time
• schedule dose of medications when sleepiness is not an issue.