TEST 3 - LEARNING ACTIVITY QUESTIONS Flashcards
Your client is experiencing stomatitis and is taking cisplatin. What kinds of food would you encourage her to avoid? Explain your answer.
Foods high in fibre, foods that are spicy, foods that contain citric acid, and foods of extreme temperatures need to be avoided to prevent increased discomfort or irritation of the oral and gastrointestinal tract mucosa.
The alkylating drug mechlorethamine causes ___________________, meaning sloughing of tissue with severe tissue damage upon intravenous infiltration.
The antidote for this alkylating agent is 1.6 mL 25 percent _____________ ____________ diluted with 8.4 mL sterile water and injected at the site of infiltration.
Often the intravenous needle, in this type of situation, is recommended to ____________ in the site to allow the use of any type of antidote to be injected directly into the site and help reverse the effects and minimize tissue damage.
extravasation
sodium thiosulphate
remain
What is a cytotoxic antibiotic?
An antibiotic that is used as chemotherapy against cancer; it is not used to treat infections because the side effects are too toxic for the treatment of infections.
What type of an anti-emetic is ondansetron?
Ondansetron is an antiserotonergic anti-emetic. It is indicated for the nausea and vomiting associated with chemotherapy. It is sometimes used with post-operative nausea.
What is the difference between cell cycle specific and cell cycle non-specific?
CCS: antineoplastic drugs that are cytotoxic during a specific cell cycle phase. CCNS: antineoplastic drugs that are cytotoxic in any phase of the cellular growth cycle.
Which of the following best describes the term nadir?
A. The client’s tolerance to the chemotherapy’s bone marrow suppressant effect
B. The maximum dose for a chemotherapy agent in reference to bone marrow suppression
C. The average number of days it takes the bone marrow to recover from a dose of chemotherapy
D. The average number of days it takes for the chemotherapy to have its peak effect on the bone marrow
D
Nadir refers to the average number of days it takes for a chemotherapeutic agent to have its peak effect on the bone marrow, which would coincide with the client’s lowest blood count and highest risk for infection and/or bleeding.
Prednisone added to a chemotherapeutic regimen contributes to all of the following except which of the following? A. Increase in blood sugar B. Decrease in bleeding tendency C. Fluid retention and risk of infection D. Sense of well-being and euphoria
B
Prednisone is added to the chemotherapeutic regimen to increase the client’s sense of well-being. It can also increase the blood glucose levels, cause fluid retention, and increase the risk of infection. It does not help decrease the risk of bleeding.
Combinations of chemotherapeutic agents are frequently used for all of the following purposes except which of the following?
A. Preventing drug resistance
B. Providing a synergistic action
C. Decreasing cost of treatment
D. Decreasing the severity of adverse effects
C
Administering a combination of antineoplastic agents allows for smaller doses of each, which can minimize the severity of side effects and help prevent drug resistance. Additionally, there is a synergistic action between some of the medications. Decreasing cost is not a benefit of combination therapy.
Which of the following is the rationale for the nurse teaching a client who is receiving cyclophosphamide to drink plenty of water/fluids? To: A. Prevent renal failure B. Prevent hemorrhagic cystitis C. Prevent liver dysfunction D. Increase the red blood cell count
B
Clients receiving cyclophosphamide should drink at least 2 to 3 L of fluid before, during, and after administration to prevent hemorrhagic cystitis.
The nurse would anticipate administering which of the following medications to clients receiving high-dose methotrexate? A. cisplatin B. bleomycin C. leucovorin D. dactinomycin
C
Leucovorin calcium is given within the first 24 to 42 hours of starting methotrexate to block the systemic toxic effect of high-dose methotrexate. It is a form of folic acid that does not require dihydrofolate reductase to produce folic acid. Therefore it is used to prevent or treat toxicity induced by methotrexate, a folic acid antagonist. All the other options are chemotherapeutic agents, which are not specifically associated with methotrexate.
Which of the following teaching tips is required for clients experiencing the adverse effect of nausea and vomiting associated with antineoplastic therapy?
A. To avoid eating any food during chemotherapy
B. That there is nothing that can be done for this effect and it will pass with time
C. To try to maintain hydration and nutrition, which are important during treatment
D. To use antacids to relieve the irritation to the stomach, which should stop the nausea
C
It is important for clients undergoing chemotherapy to maintain adequate nutrition and hydration. Several anti-emetic drugs are available that are very successful in controlling this side effect.
When teaching a client receiving paclitaxel, the nurse should prepare the client for which of the following? A. Vertigo B. Weight gain C. Arthralgias D. Hypertension
C
Myalgias and arthralgias are a common side effect of paclitaxel that the client should be prepared to expect.
Which of the following is a major dose-limiting side effect of doxorubicin? A. Hepatoxicity B. Nephrotoxicity C. Cardiomyopathy D. Hemorrhagic cystitis
C
Clients receiving doxorubicin need to be monitored for cardiac toxicity. There is a lifetime limited dose that clients are allowed to receive to minimize the occurrence of cardiomyopathy.
Which of the following laboratory results would cause the nurse to question administration of cyclophosphamide? A. Hemoglobin of 150 g/L B. Platelet count of 450 x 109/L C. Red cell count of 8 x 1012/L D. White blood cell count of 8 x 108/L
C
Cyclophosphamide causes bone marrow suppression, which is evidenced by a decrease in red blood cells, white blood cells, and platelets. A thrombocyte count of 8000 is significantly lower than normal. All the other options are within normal limits.
20. The nurse would suspect which type of cancer in a client receiving tamoxifen? A. Lung cancer B. Renal cancer C. Breast cancer D. Colon cancer
C
Tamoxifen is an antiestrogen drug useful in treating malignancies that require estrogen for growth, such as breast cancer.
Explain the rationale for not taking dairy products, iron, or calcium with tetracycline. What would be recommended if these products are not taken out of the diet?
Milk, calcium, iron, and cheeses chelate or bind up the tetracycline, resulting in decreased levels of tetracycline. Tetracycline should be taken 2 hours before or after eating the foods listed above to help alleviate this problem.
Ms. S. is taking an aminoglycoside for the treatment of a recurrent UTI. What conditions should be assessed for or laboratory studies performed before the initiation of therapy?
Aminoglycosides are nephrotoxic and ototoxic. It is important to assess renal functioning prior to therapy because these antibiotics may worsen renal dysfunction. A hearing assessment is also important before initiation of therapy because vestibular function may be impaired as well. BUN, creatinine clearance, serum creatinine, and audiometric testing should all be assessed, when indicated.
What symptoms would alert the nurse to the fact that a client is suffering form a superinfection or overgrowth of normal flora stemming from the use of tetracycline?
The client suffering from an overgrowth of normal flora because of antibiotic use may encounter the following: fever, pain, swelling, diarrhea, changes in symptoms, perineal itching, vaginal discharge, and stomatitis.
What is considered therapeutic response to antituberculous drugs?
A therapeutic response would include a decrease in symptoms such as cough and sputum production, an afebrile (no fever) state, and improved chest x-ray and negative responses to other TB-related testing measures.
Is there any concern for the female taking oral contraceptives while taking rifampin? Explain your answer.
Yes. There are concerns regarding the drug interaction between these two agents because oral contraceptives and their effectiveness are impaired by rifampin. In this scenario, the client needs to be counseled to use other forms of contraception during treatment with rifampin. Always advocate for the prevention of sexually transmitted diseases among sexually active individuals by encouraging condom use.
What parameters should be assessed while a client is taking antituberculous drugs and why?
Liver function studies should be monitored because INH (isoniazid) and rifampin may impair the functioning of the liver. Monitoring the liver function tests would help prevent possible problems.
What Drug Am I? The first anti-HIV medication.
zidovudine
What Drug Am I? This drug is the one most frequently used to treat CMV infections.
ganciclovir
What Drug Am I? A protease inhibitor that may cause nephrolithiasis (kidney stones) in some clients.
indinavir
What Drug Am I? One of the earliest antiviral drugs, active only against influenza A viruses.
amantadine
What Drug Am I? One of the newer antiviral agents, in the neuraminidase inhibitor class, used for both prophylaxis and treatment of type A and type B influenza viruses.
oseltamivir
What Drug Am I? The newest medication in the newest class of antiretroviral drug, fusion inhibitors.
enfuvirtide
What Drug Am I? The drug of choice for initial and recurrent episodes of HSV 1 and 2 as well as the varicella-zoster virus (VZV), which causes chicken pox and shingles.
acyclovir
What Drug Am I? The inhaled form of this drug is used primarily in hospitalized infants for treatment of severe lower respiratory tract infections caused by RSV.
ribavirin
Sulphonamides are associated with some significant dermatological side effects. List two of these.
There are several significant dermatological side effects associated with sulphonamides: Stevens-Johnson syndrome, epidermal necrolysis, exfoliative dermatitis, and photosensitivity.
Beta-lactamase–inhibiting penicillins do not offer any broader spectrum of coverage than regular penicillins. True or false? Explain your answer.
False. Because the beta-lactamase inhibitor–type antibiotics are resistant to the enzymes produced by bacteria that will “eat up” the antibiotic and render it ineffective, you are able to treat a larger group of bacteria, for example, those that produce beta-lactamase.
Aminoglycosides have synergistic effects with three other antibiotics or groups of antibiotics. List them.
Synergism occurs with penicillins, cephalosporins, and vancomycin.
List two major toxicities of aminoglycosides.
Two major toxicities of aminoglycosides are nephrotoxicity and ototoxicity.
Ciprofloxacin has excellent biovailability. Why is this a significant property for this drug?
Ciprofloxacin has excellent biovailability. This is significant as it has the advantage of being an oral medication that can work as well as many intravenous antibiotics.
Is there an antibiotic that can treat vancomycin-resistant Enterococcus faecium (VREF), more commonly referred to as VRE?
Linezolid, from a new class of antibiotics known as oxazolidinones, is used to treat vancomycin-resistant Enterococcus faecium, more commonly referred to as VRE.
What drug interactions or other potential problems should the nurse be concerned about with the use of ciprofloxacin and other medications ordered for Mr. G. ?
Cipro should not be used with antacids, anticoagulants, cancer chemo drugs, or theophylline. Drug interactions could possibly lead to adverse and even severe reactions.
