Wk 10: Adverse effects of cancer treatment Flashcards
During pre-assessment, what type of things are included during patient assessment?
- Psychological
- Fears
- Social
- Self care
- Eating + drinking
- Pain assessment
What are the common side effects associated w/ chemo?
- Fatigue
- Myelosuppression
- Nausea + vom
- Inc risk of infection
- Alopecia
- Diarrhoea/constipation
- Neuropathy
- Mucositis
What are the potential factors of cancer related fatigue?
- Anaemia
- Wasting
- Tumour burden
- Sleep disturbances
- Pain
- Treatment
What is myelosuppression?
- Red prod of erythrocytes, WBC + platelets
- Occurs: 7-10 days after treatment
- 20 days recovery
What are the risks of myelosuppression?
- Low erythrocytes: anaemia - treat w/ blood transfusion
- Red WBC: neutropenia
- Red platelets: thrombocytopenia
How is myelosuppression managed?
- Blood counts before treatment + before each cycle of chemo
- Low: red dose + delay treatment
What is given for the prophylaxis of myelosuppression?
High risk of neutropenia:
- Antibiotics
- Antifungal
- Antiviral
Growth factors:
- G-granulocytes (filgrastim)
- E-granulocytes (erythropoietin)
What is neutropenic sepsis?
Neutropenia w/ temp +/- symptoms of infection (medical emergency)
What is given to treat neutropenic sepsis?
Broad spectrum antibiotics:
- Tazocin 48hrs
- Meropenem 48hrs
- Ceftazidime 48hrs
- Anaerobic cover: metronidazole
What causes sickness in the body?
- Chemo activates NT
- Chemoreceptor trigger zone (brain) + GI tract
- Vomiting centre in brain = sickness
Which patients are more susceptible to nausea + vomiting?
- Female
- Under 50
- Non drinker
- Anxious
- Previous motion sickness/morning sickness
What is given for chemo triggering the chemoreceptor trigger zone?
- Dopamine: metoclopramide
- Serotonin: ondansetron
Whats is given for chemo, radiotherapy + surgery triggering the GI tract?
- Dopamine: metoclopramide
- Serotonin: ondansetron
- Cyclizine
- Hyoscine
What is given for anticipation nausea + vomiting?
Benzodiazepines
What are the types of N+V?
- Acute (w/in 24hrs)
- Delayed
- Anticipatory (fear/memory)
- Breakthrough (despite antiemetics)
- Refractory
What are the counselling points for a patient w/ anorexia + taste disturbances?
- Eat healthily + liquids
- Maintain healthy weight
- Make + freeze meals in advance
- Avoid fad diets
- Monitor weight
- Refer to dietetics
- May need artificial feeding (TPN) or via PEG/JEG
What is mucositis?
- Oral mucosa vulnerable to chemo due to rapid growth + cell turnover rate
- Inflammation of mouth = ulceration
- Inc risk of neutropenia
What is the management strategy of mucositis?
- Good mouth care
- Mouth wash
- Good nutrition