Oncology/Hematology Meds

Question 1

What causes the many side effects and adverse reactions of chemotherapy?

Answer 1

Chemotherapy destroys cancer cells and many other rapidly dividing cells which causes most of the side effects and adverse reactions.

Question 2

What are the two adverse reactions of chemotherapy?

Answer 2

1. neutropenia
2. thrombocytopenia

Most clients will continue with chemo treatment since the alternative is dying from cancer.

Question 3

What are the common side effects of chemotherapy?

Answer 3

• nausea/vomiting
• diarrhea
• stomatitis
• alopecia (hair loss)

Question 4

Nursing considerations:

Chemotherapy: neutropenia

Answer 4

Neutropenic precautions - the client is at risk of getting an infection and needs to be in a private room:

• no fresh fruits or flowers in room
• fresh water for drinking
• avoid ill people
• meticulous hand hygiene and wear gloves
• no live vaccines
• avoid invasive procedures
• fruits and vegetables need to be washed and cooked before eating
• assess for signs and symptoms of infection - WBC count and temperature

Question 5

Nursing considerations:

Chemotherapy: thrombocytopenia

Answer 5

Bleeding precautions:

• no straining
• no nail clippers
• use electric shaver
• no anticoagulants or antiplatelets meds
• limit invasive procedures
• assess platelets
• prevent falls

Question 6

Nursing considerations:

Chemotherapy: nausea and vomiting

Answer 6

• replace fluids
• monitor fluids and electrolytes
• give antiemetics

Question 7

Nursing considerations:

Chemotherapy: diarrhea

Answer 7

• replace fluids
• monitor fluids and electrolytes
• give antidiarrheals
• avoid foods that are irritating such as caffeine and fiber

Question 8

Nursing considerations:

Chemotherapy: stomatitis

Answer 8

• provide oral hygiene
• avoid alcohol mouth wash
• administer nystatin

Question 9

Nursing considerations:

Chemotherapy: alopecia

Answer 9

• get fitted for a wig
• wear head wraps
• provide gentle hair care

Question 10

Indication:

epoetin (erythropoietin)

Answer 10

Hematopoietic agent

• to increase red blood cells
• to treat anemia with chronic renal failure, HIV, and chemotherapy

Question 11

Nursing considerations:

epoetin (erythropoietin)

Answer 11

Monitor hemoglobin and hematocrit to evaluate effectiveness.

Question 12

Indication:

ferrous sulfate (iron)

Answer 12

Vitamin supplement - to treat dietary anemia.

Question 13

Nursing considerations:

ferrous sulfate (iron)

Answer 13

• take with vitamin C for better absorption (such as orange juice)
• teach that may cause constipation - encourage fluids/fiber/walking
• can cause stools to be dark and mask sign of blood
• if taking liquid, use straw as it may stain teeth

Question 14

Which medication is given to prevent an infection while a client undergoes chemotherapy?

Answer 14

filgrastim

Question 15

Mechanism of action:

filgrastim

Answer 15

Stimulates production of neutrophils.

Question 16

Which medication is given to increase RBCs?

Answer 16

epoetin

Question 17

Adverse reactions and nursing considerations:

figrastim

Answer 17

Bleeding and infection: assess for these.

Question 18

Adverse reactions and nursing considerations:

epoetin

Answer 18

Blood clots and seizures: assess BP, chest pain and neuro status.