Spec Onco2 Flashcards
Chemotherapy factors to consider
Phase Time Growth Tumor Given Regional Body systems
Which cell phase cycle drug will attack
Time or how often drug is given
Growth fraction of the cells dividing
How big or how small the tumor is
Scheduled 3 to 4 weeks
Regional chemo delivers drug to a specific site
The most common body systems with side effects are GI, blood and integumentary or skin and hair because these are where cells divide the most
Handling precautions of chemotherapy
Exposure
PPE
Excretion
Disposal
Drug exposure can be thru skin, mucous membranes, inhalation, accidental injection or ingestion
Chemo gown or isolation gown
2 pairs of gloves, 1 over gown, 1 under gown cuff
And it must be thicker and longer than standard gloves especially when handling body fluids
Goggles and face mask if splashing can occur or inhalation
Excretion of chemo drugs is 3 to 7 days after it is given
Yellow rigid container for sharps and IV containers and Yellow waste bag for gloves, gown and disposable items
In case you spilled chemotherapy drug on hand and the floor?
Wash hands with soap and water Get spill kit(ppe inside) Put on MASK first (may inhale) GOWN GLOVES GOGGLES Use absorbent pads to wipe SPILL
Chemotherapy Routes
PO
IV
Vesicant
Extravasation
Chemo drug can be given as a pill
Most chemo drugs are given IV thru a port
A vesicant is a type of chemo drug that causes necrosis if it infiltrates. Always stay with the client when receiving vesicant drug and watch the site.
The number one thing to remember with extravasation is PREVENTION. S/S are pain, swelling and no blood return
If chemo drug extravasates?
Should you wear gloves if chemo drug is given PO?
Stop the infusion and apply COLD packs to promote vasoconstriction to stop the spread of the drug then call the PHC
Yes!! Because it can be absorb thru skin
Bone marrow and stem cell Transplants
Used
Donors
Given
Are primarily used for treatment of hematologic cancers.
Sometimes necessary when too many blood cells are destroyed by chemo drugs and a transplant is needed as a rescue treatment
Donors are self, matched donor or identical sibling or twin
Stem cells are given into a vein like a blood transfusion and as time passes they settle in bone marrow and produces healthy blood cells
Complications of transplants are
Rejection signs
GI,Liver, urine,skin
Treated
Infection and Graft vs host disease ( where the graft rejects or attacks the host)
Abdominal pain.nausea, vomiting and diarrhea
Jaundice or other lover problems
Dark or tea colored urine
Skin rash, itching and redness
GVHD is treated with antirejection and steroid drugs
Major side effects of cancer/treatment
Body Image Fatigue Infection Thrombocytopenia Neutropenia Nausea and vomiting DVT (VTE) PAIN
Body image and fatigue side effect
Hair Surgery Look Cope Weight
Alopecia or hair loss not all chemo drugs causes this but most do
Sense of loss with mastectomy,amputation or scar due to surgery
We want them to look at the scar or incision
Client is coping when they want to paticipate in their care
Weight gain or weight loss and puffiness due to steroid therapy
Clients dont have too much energy and they easily get tires
Infection side effect
#1 Room Supplies Hands People, crowd IV Pneumonia Fresh and RAW Drink Bathe Temp and ANC
No. 1 cause of cancer related deaths
Private room
Must have own supplies like cups and utensils and toiletries and steth
Proper handwashing also after touching a pet
Limit people (visitors and nurses), avoid crowds
Change IV tubing daily
Cough and deep breathe to prevent pneumonia
No fresh flowers,potted plants and RAW vegetables and fruits
Drink Only Fresh water
Bathe warm moist areas like groin 2x a day
Watch for slight increase in temp it may mean sepsis and clients must go to hospital if they have a 100.4°f or 38°c, Also must monitor for absolute neutrophil count
Neutropenia side effect
Calculate ANC Value Anc Indicates Nadir Defense Neutropenia+infection=
Neutropenia is a decrease of the number of neutrophils or mature WBC in the blood
Best way to know is calculate ANC
2500 - 8000 cells/mm
ANC indicates how well client fights infection and how many wbcs are neutrophils
Nadir is lowest point
Neutrophils are the first line of defense inside body to protect us from infections
Sepsis and could lead to shock and death
Neutropenia risk factors
Age Eat Vitamin Diseases and hematologic malignancies Also Caused by
Treatment:
Precautions: V/S Soap Room Invasive Acetaminophen
The very old and the very young are at most risk
They dont eat well, malnourishment due to lose of appetite
Vitamin b12 and folic acid deficiency contribute to neutropenia
DM,COPD,AIDS, advanced metastatic disease, leukemias, lymphomas and myelomas
Cause of cancer treatment
Antibiotics and implement neutropenic precautions
Do everything we can to prevent an infection and neutropenic precautions include all general ways to prevent infection plus:
V/S every 4 hours
Antimicrobial
Private room with door closed and posted sign
NO invasive procedures like Injections, rectal exam, rectal meds, catheters and NG tubes
Acetaminophen should be limited due to its toxicity to liver
DVT (VTE) side effect
#2 Malignancy External Invasion Chemo drugs
What are we most afraid of in DVT?
Second leading cause of death in cancer clients
Malignancy is a risk factor for DVT due to
Prolonged bedrest
Surgery
Use of central line
External compression of vessels by the tumor
Invasion of vessels by the tumor
Certain chemo drugs are also risk factors
Development of a PE
Thrombocytopenia side effect
Risk factors
Diseases
Meds
Result of
Decrease in number of platelets which is responsible for clotting
Advanced metastatic disease, hematologic malignancies, bleeding disorders such as hemophilia and ITP (idiopathic thrombocytopenia purpura)
Anticoagulant medications such as Aspirin
As a result of cancer treatment
Thrombocytopenia assessment
Check for Change Bleeding Bruising Oozing Change of meds
History,V/S,Pulse oximetry
Change in LOC, the client may report headache and pupil changes
Bleeding from rectum, eyes, ears,nose or mouth
Ecchymosis,petechiae, purpura
Oozing from puncture site or operative site
Change of IM medications to PO
