Mod 13 Flashcards
Identify the risks of taking chemoprevention drugs.
(tamoxifen)
Proliferation of endothelial tissues → endothelial cancer
Hot flashes, vaginal discharge, DVT/CV
Bone marrow suppression
Hair loss
GI upset
Loss of appetite
Peripheral neuropathy
Describe the side effects of chemotherapy and the associated nursing interventions.
Side Effects:
Nausea & vomiting
Hair loss
Loss of appetite
Fatigue
Bone marrow suppression
Nursing Interventions:
Vincristine:
Check deep tendon reflexes → Achilles reflex/tingling
Monitor IV sites for infiltration
Monitor for alopecia
Monitor for constipation → prepare to administer stool softeners or laxatives
Fluorouracil:
Monitor for GI upset & weight
Monitor CBC
Tamoxifen:
Blocks Estrogen receptors on breast cancer cells & thins endothilial lining
Estrogen is decreased = cancer cell is decreased
#1 concern: Endothelial cancer
Monitor for GI upset
Monitor for hot flashes
Monitor for visual disturbances
Monitor for symptoms of thrombophlebitis
Monitor bone density
Monitor cholesterol levels
Methotrexate:
Monitor for bone marrow suppression → CBC
Monitor for fever from WBC decrease
Monitor for bleeding (mucositis)
Monitor kidney
Explain the rationale for the dosing regimens of chemotherapy.
Kills both cancerous and healthy cells. Need to limit the amount given for the least amount of harm. Time in between doses allows the normal cells to repopulate.
What are the advantages and disadvantages of chemotherapy?
Advantages:
Relieves symptoms of cancer
Kills cancer cells
Stops proliferation of cancer cells
Disadvantages:
Chemotherapy also kills healthy cells (nonspecific) and bad cells
Nausea/Vomiting
Bone marrow suppression
Anemia
Hair loss - alopecia
Organ toxicity
Intermittent chemo because it kills all cells good and bad so it allows cells to come back in between doses
Chemotherapy goal is to produce 100% kill of neoplastic cells so using COMBO drug therapy helps overcome resistance and allow less of each drug to be used
Risk of reoccurring injury is directly related to the total cumulative dose so healthcare workers would keep track of the total cumulative lifetime dose and make sure the maximal allowed dose is not exceeded past 550
Identify the physiologic rationale for dose limiting toxicity of most chemotherapy agents.
-Stop treatment when find dose limiting toxicity
Bone marrow suppression dose limiting toxicity:
Monitor platelet count, monitor erythrocytes and neutrophils, assess for fever
Describe the patient teaching principles for those taking cyclophosphamide.
Patient Teaching:
Discuss with client early about hair loss and alopecia – hair will grow back after treatment
Avoid crowds bc bone marrow suppression
Report nausea & vomiting
Void before taking a dose and increase fluid intake to prevent cystitis
Avoid pregnancy
Increase fluids and monitor blood in urine because of acute hemorrhagic cystitis
