Oncology Flashcards
1
Q
Extravasation
A
The escape of blood or lymph from their proper vessels into surrounding tissues.
2
Q
Vesicants
A
An agent that causes blistering.
3
Q
Nadir
A
The point at which blood cell counts are at their lowest after a chemotherapy treatment.
4
Q
thrombocytopenia
A
A blood disease characterized by an abnormally low number of platelets in the bloodstream
5
Q
leukopenia
A
when the levels of WBCs in your blood are lower than average.
6
Q
desquamation
A
The shedding of the outer layers of the skin
7
Q
intrathecal
A
- within a sheath. 2. through the theca of the spinal cord into the subarachnoid space.
8
Q
Uncontrolled cell growth
A
Cancer
9
Q
2nd leading cause of death in the U.S.
A
Cancer
10
Q
Causes of cancer
A
some genetic tendencies, some related to environmental expose, some related to infectious agents
11
Q
Infectious agents that can cause cancer
A
human papillomavirus (HPV), hepatitis B virus (HBV), hepatitis C virus (HCV), and Helicobacter pylori (H. pylori),
12
Q
Cancer can be prevented through
A
behavioral changes, vaccination, or treatment of the infection.
13
Q
A process that begins when an abnormal cell is created by the genetic mutation of a cell’s DNA
A
Cancer pathophysiology
14
Q
Increased cell growth
A
proliferation
15
Q
Cancer cells that don’t always multiply rapidly, but do increase & spread without cell “boundaries”
A
proliferation
16
Q
Cells should grow into the mature type- if not they remain like immature or fetal cells…
A
differentiation
17
Q
UN-LIKE the mature cell
A
undifferentiated
18
Q
Pre-malignant or malignant
A
differentiation
19
Q
Number 1 Carcinogen
A
Tobacco smoke
20
Q
Environmental Carcinogens:
A
tobacco, exposure to occupational chemicals, asbestos, benzene
21
Q
30% of cancer can be traced to
A
Smoking and 2nd hand smoke
22
Q
Environmental Carcinogen drugs
A
pesticides
23
Q
Environmental Carcinogens viruses
A
Epstein-Barr, HPV, h. pylori
24
Q
Environmental Carcinogen: radiation
A
sun, treatment, radon, nuclear exposure
25
Potential causes of mutations from diet
eating too many animal proteins/fats, alcohol, and cured foods
26
Epstein-Barr is linked to
mononucleosis
27
Potential causes of mutation relating to immune response
Autoimmune disorders and medications
28
Potential causes of mutations in genetics
chromosome/genes (BRCA1 &2?)
29
TAA’s (proteins)
Tumor associated antigens on surface of cancer cells
30
lymphokines& Tumor Necrosis Factors=
CELL DEATH
31
cytotoxic B lymphocytes & Killer T cells kill cells with
TAA
32
7 Warning Signs: CAUTION
C hange in bowel/bladder
A sore does not heal
U nusual bleeding
T thickening or lump
I indigestion
O bvious change in wart
N agging cough
33
Change in bowel/bladder could indicate
Colon, prostate, or bladder cancer
34
A sore that does not heal could indicate
Leukemia or lymphoma
35
Unusual bleeding could indicate
Leukemia
36
Thickening or a lump could indicate
Breast cancer or lymphoma
37
Indigestion could indicate
Cancer of the GI tract
38
Obvious change in a wart could indicate
Skin cancer
39
A nagging cough could indicate
Lung cancer or lymphoma
40
Baseline breast screening is done at age
35
41
Breast screening is performed
mammo over 40y annually
42
Colon screening is performed
starting at age 45: colonoscopy every 10 years
43
occult blood is tested
yearly
44
Virtual colonography is performed
Every 5 years
45
Prostate exam is performed
PSA & digital exam is done annually starting at age 50
46
PSA
Prostate specific antigen
47
What is PSA?
PSA is a protein produced by the prostate gland
48
Pap smear is performed:
Every 3 years when over 21 yrs of age
49
Americans are too sedentary and their diet is too high in
saturated fats
50
Prevention education includes the dangers of
smoking and excessive alcohol use
51
Primary cancer health action
Prevent
52
Primary cancer promotions
Educate about risks
Diet & lifestyle changes
Cancer prevention programs
53
Secondary cancer health action
Find early
54
Secondary cancer health action
Identification of at risk groups
Cancer Screening
55
Classification of cancer:
from embryonic skin, gland, mucous membranes of resp. tract, GI & GU
Carcinomas
56
Known as “solid tumors”
Carcinomas
57
Classification of cancer:
connective tissue, muscle, bone, fat
Sarcomas
58
Classification of cancer:
hematopoietic system (bone marrow)
Lymphoma, leukemia, and Hodgkins/Non Hodgkins
59
Known as “liquid” or “blood” tumors
Lymphoma, leukemia, and Hodgkins/Non Hodgkins
60
Glandular tumors
adenocarcinomas
61
Tumors of the bone
Osteosarcoma
62
Grading and staging of tumors is determined by
A pathologist
63
pattern of growth in which cells lack normal characteristics and differ in shape and
organization with respect to their cells of origin; usually, anaplastic cells are malignant (Grade IV)
anaplasia
64
The presence of cells of an abnormal type within a tissue, which may signify a stage
preceding the development of cancer (grades I-III)
dysplasia
65
Grading by cell appearance:
I
slightly different (dysplagia)
66
Grading by cell appearance:
II
moderate dysplagia
67
Grading by cell appearance:
III
very abnormal -poor differentiation
68
Grading by cell appearance:
IV
Immature, fetal, not same as mature cell (anaplastic)
69
Grade IV is sometimes difficult to identify
Cell origin
70
cells or tissues that have lost their mature or specialized features
Anaplastic
71
How different is the cell?
Well differentiated
Similar
72
How different is the cell?
Moderately differentiated
Less similar
73
How different is the cell?
Extremely differentiated
Anaplastic
74
Stage 0
in situ
75
In situ
the earliest stage, non-invasive
76
Stage 1
local- in tissue of origin
77
Stage 2
limited, local
78
Stage 3
extensive, regional lymph node or tissue extent
79
Stage 4
metastasis
80
Staging:
present, not invading
stage 0
81
Staging:
In tissue of origin, potential for motion
Stage 1
82
Staging:
Great potential to spread
Stage 2
83
Staging:
extensive but no evidence of metastasis
Stage 3
84
Staging:
Travelled to different area of body
Stage 4
85
Grading scale used for prostate
Gleason scale
86
The lymph system can be an indicator of
where the tumor is
87
Tumor is sometimes washed towards
lymph nodes closest to origin
88
metastasis
cancer has spread to a different body part than where it started
89
Common symptoms of brain metastasis
Headaches, seizures, vertigo, vision problems
90
Common symptoms of respiratory metastasis
Cough, hemoptysis, dyspnea
91
Common symptoms of lymph node metastasis
lymphadenopathy
92
Common symptoms of liver metastasis
Hepatomegaly, jaundice
93
Common symptoms of skeletal metastasis
fractures, pain, spinal cord compression
94
CEA
carcinoembryonic antigen (associated with bowel cancer)
95
CA125
ovarian cancer indicator
96
Immature Cells
blast or stem cells
97
cells that look like “fetal” or immature cells can be found
in the blood with certain cancers
98
Diagnostic labs
CBC, WBC
99
diagnostic tests
Biopsy-
MRI
CAT
Endoscopy
Xray
PET scans
100
the 3 goals
CURE
CONTROL
PALLIATION
101
the 4 treatments
SURGERY
RADIATION
CHEMOTHERAPY
BIOLOGIC AGENTS
102
Types of cancer surgery
debulk, radical, supportive
103
Types of radiation
internal or external
104
Curative surgery
Completely removes all cancer/tumor
105
Type of surgery such as colostomy for obstruction, insert drainage tubes, PEG’s etc
Supportive (palliative)
106
Surgery for prevention
Prophylactic
107
If there is numbness, there may be ______ of the spine
compression
108
Lung and breast cancer can be found in the
brain
109
abnormal size or consistency of the lymph nodes
lymphadenopathy
110
Colon cancer will first travel to
Liver
111
Prostate and breast cancer will travel to
the bones
112
TNM
Tumor, Node, Metastasis
113
TNM Classification:
T
Tumor size
114
TNM Classification:
N
Lymph nodes involved
115
TNM Classification:
M
metastasis
116
Gold standard of cancer diagnostics
biopsy
117
cells that look like “fetal” or immature cells can be found
in the blood with certain cancers
118
diagnostic labs
CBC, WBC
119
Abnormal PSA test could be benign but suspicious if
number drastically changes
120
Tumor markers
Tumor specific antigens (CEA, PSA)
121
Tumor specific antigens can be used to
diagnose or determine treatment success
122
CEA can be used to determine
uterine or colon cancer
123
PET
Positron emission tomography
124
This test uses a safe injectable radioactive chemical called a radiotracer and a device called a _____ scanner.
PET scan uses a PET scanner
125
Diagnostic test can be used all over body and can see organ function in real time
PET scan
126
Non invasive 3D imagine diagnostic test
MRI
127
Diagnostic test:
cross section x-ray of body
CAT scan
128
Immature cells in blood are usually a sign of
Leukemia
129
Diagnostic test done annually after remission
CAT scan
130
Curing cancer can be difficult in people with
comorbidities
131
Controlling side effects of tumor
Palliation
132
Examples of palliation
pain control or colostomy for colon cancer
133
Clear margins indicate
tumor was within surrounding tissue
134
sometimes tumor is removed with
surrounding tissue
135
giving drugs at a certain point of the cell cycle causes a profound effect on
the cell
136
CELL CYCLES:
G1
dormant
137
CELL CYCLES:
S
DNA & RNA synthesized
138
CELL CYCLES:
G2
RNA made
139
CELL CYCLES:
M
Mitosis
140
CELL CYCLES:
G 0
resting
141
Energy used in high doses to break the DNA chain in cancer cells
Ionizing radiation
142
2 kinds of radiation
Internal & External
143
Radiation effects cells in certain
CELL CYCLES
144
Some tumors are more sensitive then others to
radiation
145
treatment that is good for Hodgkin’s, Testicular cancer
radiation
146
Treatment that has poor results with Gliomas, Melanoma
radiation
147
External radiation uses ______ radiotherapy
Beam
148
Internal radiation uses
implants
149
Internal radiation is also called
brachytherapy
150
External Radiation is also called
teletherapy
151
Patient is alone in room during external radiation. EXACT spot to radiate is marked with identification such as
TATOO, PERMANENT INK MARKERS
152
Wet Desquamation care:
wash gently & prevent infection
153
Slough of upper layer of skin
Wet Desquamation
154
Happens to 30% of patients 3 weeks after treatment
Wet Desquamation
155
treatment includes cleaning and covering skin with a light, non-stick dressing
Wet Desquamation
156
Erythema from radiation
Dry Desquamation
157
Treatment includes cleaning skin with cool or warm water. no alcohol on skin
Dry Desquamation
158
Fluids should be given to patients with dry or wet desquamation?
both
159
type of ointment that is safe for dry desquamation
vitamin ointment
160
Patient teaching for radiation:
Must avoid strong ______esp. over site of radiation
Sunlight. Wear sunscreen
161
Patient teaching for radiation:
Eat ____ hours BEFORE treatment to decrease nausea:
2-3 hours
162
Patient teaching for radiation:
Type of meal that can be eating before radiation
high protein, high carb, low residue
163
Patient teaching for radiation:
Crowds are.....
sources of infection!!
164
Patient teaching for radiation:
Women should avoid _____ during course of treatment
pregnancy
165
Patient teaching for radiation:
Patients are tired because .......
WBC and RBC are destroyed
166
A patient receiving radiation for breast cancer would experience which of the following side effects?
A. severe fatigue
B. mucositis
C. alopecia
D. vomiting
A. severe fatigue
167
(Brachytherapy) Internal forms of radiation:
Source is placed inside tumor (seeds)
Interstitial
168
(Brachytherapy) Internal forms of radiation:
Source is placed inside body cavity (cervical, breast, lung)
Intracavity
169
(Brachytherapy) Internal forms of radiation:
Meds that are p.o. or IV that act as systemic radiation (I-131)
Radiopharmaceutical agents
170
Brachytherapy commonly used to treat prostate cancer
interstitial
171
All forms of brachytherapy emit ______ & carry specific safety precautions
radiation
172
Internal radiation type:
Source of radiation is a sealed form of radium, cesium, etc. Placed in cavity or next to tumor
Intracavity
173
Internal radiation type:
Used for local tumors such as mouth, cervix, testes, prostate
Intracavity
174
Internal radiation type:
Bedrest is recommended to help avoid displacing implant
Intracavity
175
Internal prostate seeds are kept in the body for how long?
Permanently
176
When getting treatment with prostate seeds, avoid being around children for
the length of treatment
177
Cervical Brachytherapy Procedure:
Give enema, douche & foley before insertion to avoid
BM and voiding
178
Cervical Brachytherapy Procedure:
Implant remains in for _____ hours! After removal -enema & douche & remove catheter
48-144 hours
179
Cervical Brachytherapy Procedure:
Patient is in hospital for ____ days
1-3 days
180
Cervical Brachytherapy Procedure:
After removal of implant
enema & douche & remove catheter
181
Cervical Brachytherapy Procedure:
Side effects
Fatigue, diarrhea, bladder irritation, decreased blood count, vaginal dryness
182
Cervical Brachytherapy Safety:
Wear lead apron if ___ min with patient
>30 min
183
Cervical Brachytherapy Safety:
Stay greatest distance from pt. ___ ft is preferred in room
>6 ft
184
Cervical Brachytherapy Safety:
Trash, linen & food trays must be
screened by radiation officer before removal
185
Cervical Brachytherapy Safety:
Patient must have private room with _____ to minimize exposure
bathroom
186
P.O. radiation
UNSEALED INTERNAL RADIATION= Radiopharmaceuticals= I-131
187
Unsealed internal radiation safety and procedure:
Isolate patient, ID room as radiation
Use ______, dispose of in trash which is left in room with linens for radiation officer to clear
paper plates
188
Unsealed internal radiation safety and procedure:
Rotate staff to minimize exposure
Don double _____, _______, and _______
shoe covers, gown, and gloves
189
Unsealed internal radiation safety and procedure:
No need for
lead apron (too restrictive, not effective for this type of radiation)
190
Unsealed internal radiation safety and procedure:
Body fluids can go in toilet & be
flushed several times to clear with lid down
191
Unsealed internal radiation safety and procedure:
2 weeks prior patient must start a _____ diet
low iodine diet
192
Unsealed internal radiation safety and procedure:
Patient is hospitalized for _____ days to keep them isolated
2-3 days
193
Unsealed internal radiation is commonly used for
Thyroid cancer
194
Principles of Gamma radiation:
TIME: minimize exposure to
patient and limit family/visitors
195
Principles of Gamma radiation:
Pregnant nurses
CANNOT take care of patient-
196
Principles of Gamma radiation:
SHIELDING:
private room, lead lined walls good
197
Principles of Gamma radiation:
DISTANCE:
maintain distance needed from patient. 6ft or greater is preferred
198
Principles of Gamma radiation:
if implant falls out it must be handled with _______
FORCEPS & placed in lead lined garbage- Radiation officer is responsible for radiation monitoring
199
Goal of chemotherapy
to destroy a % of tumor & allow body to destroy the rest
200
Chemotherapy can affect normal cells with high rate of growth/cell turnover such as
hair follicles, lining of GI tract & bone marrow
201
Chemotherapy can cure:
A.L.L., Hodgkins, Testicular
202
A.L.L.
Acute lymphocytic (or lymphoblastic) leukemia
203
Chemo can control:
Non-Hodgkins, ovarian, breast
204
Chemo palliation:
to decrease size of tumor causing pain/obstruction
205
Chemo for non-Hodgkins is _______
aggressive
206
Chemo routes
oral
intramuscular
Intravenous
Subclavian catheters
implanted ports
intracavity
Intrathecal
207
implanted ports are good because
patients require a lot of blood draws and frequent IV therapy
208
inhibiting or preventing the growth and spread of tumors or malignant cells.
antineoplastic
209
cytotoxic B lymphocytes and Killer T cells use these TSA’s to
identify and kill abnormal cells
210
melanomas are very
aggressive cancers
211
arising from plasma cells
myeloma
212
chemo that bind with DNA or cell proteins to kill cells
Alkylating Agents
213
Chemo drug:
good for slow growing leukemias, lympomas, breast/ovarian, testicular, pancreas
Alkylating Agents
214
Chemo drug:
need to check BUN and creatinine before taking
cisplatin
215
Chemo drug:
must be very hydrated before hanging
Alkylating Agents
216
Chemo drug:
can cause renal toxicity and is an irritant
cisplatin
217
Chemo drug:
Amifostine(Ethyol) and Mesna are protectant (rescue meds) and given
before chemo
218
Chemo drug:
Protectant drug given to prevent h. cystitis
mesna
219
Chemo drug:
ifosfamide is damaging to the kidneys and is given concurrently with
mesna
220
Number 1 chemo drug is
Mustargen
221
Chemo drug:
Replace necessary cellular metabolites = folic acid
Antimetabolites
222
Chemo drug:
Antimetabolites that causes renal and liver toxicity
5-FU and methotrexate
223
Chemo drug:
is the rescue med, protects the normal body cells from the toxic effects of methotrexate
leucovorin
224
Chemo drug:
need folic acid supplements(1000 mg/day min)
Antimetabolites
225
Chemo Drug:
blocks folic acid uptake
Antimetabolites
226
Chemo Drug:
vesicants that cause necrosis
Antineoplastic Antibiotics
227
Chemo drug:
infiltration can cause infection
vesicants
228
Chemo drug:
side effects are cardiotoxicity and left ventricular disfunction, turns urine and body fluids red
bleomycin
229
Chemo drug:
toxic to respiratory; causes pulmonary fibrosis
Antineoplastic Antibiotics
230
Chemo drug:
cell cycle specific
Mitotic Inhibitors/Plant Alkaloids
231
Chemo drug:
kill cells as mitosis begins
Mitotic Inhibitors/Plant Alkaloids
232
chemo drug:
treats breast, small cell lung, sarcomas, hodgkin's, ovarian
Mitotic Inhibitors/Plant Alkaloids
233
Chemo drug:
The higher the dose the higher the chance of nerve damage
Mitotic Inhibitors/Plant Alkaloids
234
Chemo drug:
causes a ton of side effects; alopecia and myelosuppression being the main ones
Mitotic Inhibitors/Plant Alkaloids
235
How to prevent extravasation
Use central line or a recently placed IV; monitor infusion continuously
236
A subcutaneous wash out involving injections of normal saline to the extravasation area.5,9 This must be performed by appropriately trained professionals and may require multiple treatments
Flush out technique
237
How to treat extravasation
Use cold or heat pack; cold to reduce swelling, heat to increase reabsorption
238
Drug class:
specific to tissue/hormone; they decrease the amount of hormone or block receptor sites in tumor
Hormone modulator
239
Drug:
slows rate of growth and spread of disease but can cause blood clots
Hormone Modulator
240
Drug:
hormone regulator sometimes given for years
Tamoxifen
241
Drug class:
when using an estrogen blocker the female patient will experience menopause very quickly
Hormone modulator
242
Drug class:
block very specific proteins in cancer cells
with no effect on normal cells
Protein Tyrosine Kinase Inhibitors
243
Drug :
treats chronic myelogenous leukemia; PO med that is very expensive
gleevec (imatinib)
244
B lymphocyte antibodies that are created in response to lab antigen= kill cancer cells
monoclonal antibodies
245
Drug:
monoclonal antibodies treatment for leukemias, RA, non-hodgkins
Rituxan (rituximab)
246
Drug:
monoclonal antibodies treatment for breast cancer for HER2 +
Herceptin (trastuzumab)
247
A group of potentially life-threatening conditions that may happen within hours after cancer treatment. Dying cells release large amounts of potassium, phosphate, and uric acid into the blood
Tumor lysis syndrome
248
ANT
anemia, neutropenia, thrombocytopenia
249
Using a lower dose but a combination of drugs
synergic effect
250
When WBC does down to lowest level 1-2 weeks after treatment
myelosuppression
251
Fever and low BP is sign of
systemic infection
252
Patient with low platelet (thrombocytopenia) is at risk for
internal bleeding
253
Monitoring temp for fever and signs of Nadir
100.4 3x in 24rs
101.3 1x in 24 hrs
254
If absolute neutrophil count is <1000/mm
Reverse isolation is needed; minimum mask and gloves
255
neutropenic precautions
Avoid flowers, produce, raw meats, razors, injections, manicures, pedicures, sick people and crowds
256
Stomatitis and alopecia are side effects of
both chemo and radiation
257
Care for stomatitis
soft toothbrush, mouth care q2h; normal saline or baking soda rinses (not commercial mouthwashes), lidocaine rinse
258
If taking Adriamycin
keep out of sun
259
chemo is very drying so skin care involves
moisturizing
260
Zofran has 80% success with
Preventing nausea and vomiting
261
Number 1 complaint is
fatigue
262
Medication that blocks neurokinin (vomiting control center)
Emend
263
SE Clotting/ bleeding:
Monitor lab values for
DVT, embolism, unusual bleeding,
264
SE Clotting/ bleeding:
Assess for
petechiae, gum bleeding, OB stool, altered mental status
265
SE Clotting/ bleeding:
Do not use or give
razors, rectal thermometers, aspirin, or ibuprofen
266
Hormone regulator and some cancers can cause high risk of
clotting
267
Precautions for Administration of Chemo:
when preparing chemo
Wear double gloves & mask
268
Do not spray chemo in syringes
into the air
269
a man-made form of granulocyte colony-stimulating factor; stimulates the growth of white blood cells in the body
NEUPOGEN
270
a man-made form of granulocyte colony-stimulating factor; stimulates the growth of red blood cells in the body
Epogen
271
Neupogen stimulates the bone marrow to produce
WBC
272
Medical emergency; obstruction of superior vena cava by tumor- SOB, facial edema, headache, seizures
Superior vena cava syndrome
273
Signs and symptoms of Hypercalcemia
lethargy, muscle weakness, EKG changes
Ca > 12mg
Treat: Fluids!
274
Allopurinal(zyloprim)
treatment that reduces uric acid in body
275
Med that causes diarrhea to reduce potassium level in blood
kayexalate
276
Which of the following findings are possible in a patient with tumor lysis syndrome?
A. hypernatremia
B. edema of face and arms
C. epistaxis
D. hyperuricemia
D. hyperuricemia
277
Several kinds of analgesics can be used because pain is
difficult to control
278
Care with goal of symptom treatment
palliative care
279
What statement indicates that the client understands teaching about neutropenia?
A. “I need to use a soft toothbrush.”
B. “I have to wear a mask at all times.”
C. “My grandchildren may get an infection from me.”
D. “I will call my doctor if I have an increase in temperature.”
D. “I will call my doctor if I have an increase in temperature.”
280
A client is undergoing radiation therapy and asks the nurse about skin care for the exposed area. Which statement by the nurse is most accurate?
A. “No products work well to reduce the skin reactions you get from radiation.”
B. “No one product works best, so you can choose what you would like to use.”
C. “The only medication that works well for skin reactions is very expensive.”
D. “No good studies on skin care with radiation have been conducted to date.”
A. “No products work well to reduce the skin reactions you get from radiation.”
281
In evaluating dietary teaching for a client with chemotherapy-induced neutropenia, the nurse becomes concerned when the client makes which food choice?
A. Fruit salad
B. Applesauce
C. Steamed broccoli
D. Baked potato
A. Fruit salad
282
What teaching is essential for a client who has received an injection of iodine-131?
A. “Do not share a toilet with anyone else or let anyone clean your toilet.”
B. “You need to save all your urine for the next week.”
C. “No special precautions are needed because this type of radiation is weak.”
D. “Avoid all contact with other people until the radiation device is removed.”
A. “Do not share a toilet with anyone else or let anyone clean your toilet.”
283
A client’s radiation implant has become dislodged overnight, and the nurse finds it in the client’s bed. What does the nurse do first?
A. Assess the client’s skin for radiation burns.
B. Use tongs to put the implant into the radiation container.
C. Notify the safety officer and move the client to a different room
D. Don gloves and attempt to replace the implant.
B. Use tongs to put the implant into the radiation container.
284
client is receiving a chemotherapeutic agent intravenously through a peripheral line. What is the nurse’s first action when the client reports burning at the site?
A. Check for a blood return.
B. Slow the rate of infusion.
C. Discontinue the infusion.
D. Apply a cold compress
C. Discontinue the infusion.
285
A client receiving intravenous chemotherapy asks the nurse the reason for wearing a mask, gloves, and gown while administering drugs to the client. What is the nurse’s best response?
A. “These coverings protect you from getting an infection from me.”
B. “I am preventing the spread of infection from you to me or any other client here.”
C. “The policy is for any nurse giving these drugs to wear a gown, gloves, and mask.”
D. “The clothing protects me from accidentally absorbing these drugs.”
D. “The clothing protects me from accidentally absorbing these drugs.”
286
A client’s spouse reports that the last time the client received lorazepam (Ativan) before receiving chemotherapy, the client was extremely drowsy and didn’t remember the trip home. Which is the nurse’s best action?
A. Hold the dose of lorazepam for this round of chemotherapy.
B. Explain that this is a normal response to the drug.
C. Perform a Mini-Mental State Examination.
D. Document the response in the client’s chart.
A. Hold the dose of lorazepam for this round of chemotherapy.
287
A client is on chemotherapy and has a platelet count of 25,000. Which intervention is most important to teach this client?
A. “Eat a low-bacteria diet.”
B. “Take your temperature daily.”
C. “Use a soft-bristled toothbrush.”
D. “Avoid alcohol-based mouthwashes.”
C. “Use a soft-bristled toothbrush.”
288
A woman with chemotherapy-induced bone marrow suppression has received filgrastim (Neupogen). Which laboratory finding indicates that this therapy is effective for the client?
A. Hematocrit is 35%.
B. Hemoglobin is 14/dl
C. Red blood cells 5/mcl
D. White blood cells (neutrophils) 3500
D. White blood cells (neutrophils) 3500
289
What is the priority problem for a client experiencing chemotherapy-induced anemia?
A. Risk for injury related to fatigue Correct
B. Fatigue related to decreased oxygenation
C. Body image problems related to skin color changes
D. Inadequate nutrition related to anorexia
A. Risk for injury related to fatigue Correct
B. Fatigue related to decreased oxygenation
