test 3 Flashcards
Chemotherapy complications
N/V/anorexia
Immunosuppression/neutropenia
Alopecia
Oral effects- Mucositis and stomatitis
Anemia and thrombocytopenia
Neutropenic precautions
Private room
* Client in mask if they leave
the room
* Protect from sources of
infection
* Frequent hand hygiene
* No ill visitors
* Avoid invasive procedures
* Dedicated equipment in
room
Immunosuppression/neutropenia education
Avoid crowds
* Daily temp
* Avoid food that could
contain bacteria
* Avoid yard work
* Avoid cleaning pet’s litter
box
* Discard beverage sitting
at room temp >1 hour
* Wash dishes in hot,
soapy water or
dishwasher
* Do not share toiletry or
personal hygiene items
w/others
when should you report a fever during chemo?
Report temp > 37.8 C (100 F) immediately
what kind of catheter do you use for chemo?
central catheter
Nursing considerations for Nausea and vomiting
Give antiemetics before chemo and when
CINV present
» Administer for several days afterwards
– Non-pharmacological methods to reduce
nausea
– Remove vomiting cues
– Calorie counts to ensure adequate intake
» Liquid nutritional supplement PRN
– Megesterol to increase appetite
– Mouth care prior to meals – enhance appetite
oral effects complications for chemo nursing considerations
Education
– Rinse mouth w/0.9% NaCL, room-temp
tap water, salt/soda water
» Frequency depends on mucositis
– Gentle flossing/brushing
– Rinse mouth before/after meals
– Meds to prevent infection as prescribed
– Soft, bland foods/supplements high in
calories
– Avoid alcohol/smoking
– At least 2L water/day
adverse effects of cytotoxic chemo
unintentional harm to normal cells
* i.e. – mucous membranes in GI tract, hair follicles,
bone marrow
Alopecia education
Avoid using damaging hair care measures
– Consider cutting short before treatment
– After hair loss – protect from sun exposure
when does alopecia normally begin?
7-10 days after treatment and hair should return about 1 month after treatment
Anemia/thrombocytopenia nursing considerations
Nursing (thrombocytopenia)
– Monitor for petechiae, bleeding (gums,
nosebleeds), frank blood in stool, urine, vomit
– Bleeding precautions
» Avoid IV’s/injections
» If necessary – smallest needle
possible
» Pressure for 10 minutes
» Handle gently/avoid trauma
– Admin thromopoietic meds to stimulate platelet
production
– Prepare to admin platelets if count
<10,000/mm3
what is brachytherapy
internal – body fluids contaminated, body waste
disposed of appropriately
Radiation placed close to target tissue
* Tumor and limited amount of surrounding
tissues
* Clients remain in facility until therapy complete
– Seed implants may be able to go home
brachytherapy nursing considerations
Private room, door closed
* Sign on door warning of radiation source
* Wear a dosimeter film badge
– Records personal amount of radiation
exposure
* Limit visitors to 30 minutes, remain 6 feet from
source
Nursing (cont’d)
* Lead apron when providing care
* Lead container in room, tongs available
* Follow protocol re: removal of dressings and
bedding
– Generally, kept in room until rad source is
removed
what is teletherapy
External does not cause client to be radioactive
teletherapy
Skin over target area marked with tattoos
– Guide position of external rad source
* Well balanced meal
– No red meat
– Can cause altered taste
* Fatigue
– Schedule activities w/rest periods
* Monitor for skin/mucous membrane injury
– Skin: blanching, redness, sloughing,
hemorrhage, outer layer of skin shedding
– Mouth: mucositis, dry mouth
– Neck: diff swallowing
– Abdomen: gastroenteritis
