Chapter 15: Cancer

A patient with metastatic colon cancer has severe vomiting after each administration of chemotherapy. Which action by the nurse is appropriate?

Administer prescribed antiemetics 1 hour before the treatments.

The nurse is caring for a patient who smokes 2 packs/day. Which action by the nurse could help reduce the patient's risk of lung cancer?

Discuss risks associated with cigarettes during each patient encounter.

A chemotherapy drug that causes alopecia is prescribed for a patient. Which action should the nurse take to support the patient's self-esteem?

Encourage the patient to purchase a wig or hat to wear when hair loss begins.

A patient with a large stomach tumor attached to the liver is scheduled for a debulking procedure. What should the nurse teach the patient about the outcome of this procedure?

Decreasing the tumor size will improve the effects of other therapy.

The nurse is caring for a patient diagnosed with stage I colon cancer. When assessing the need for psychologic support, which question by the nurse will provide the most information?

"Can you tell me what has been helpful when coping with past stressful events?"

A patient undergoing external radiation has developed a dry desquamation of the skin in the treatment area. The nurse teaches the patient about the management of the skin reaction. Which statement, if made by the patient, indicates the teaching was effective?

"I can buy some aloe vera gel to use on my skin."

The home health nurse is caring for a patient who has been receiving interferon therapy for treatment of cancer. Which statement by the patient indicates a need for further assessment?

"I rarely have the energy to get out of bed."

The nurse teaches a postmenopausal patient with stage III breast cancer about the expected outcomes of cancer treatment. Which patient statement indicates that the teaching has been effective?

"I will need follow-up examinations for many years after treatment before I can be considered cured."

The nurse teaches a patient who is scheduled for a prostate needle biopsy about the procedure. Which statement by the patient indicates that teaching was effective?

"The biopsy will help decide the treatment for my enlarged prostate."

The nurse receives change-of-shift report on the oncology unit. Which patient should the nurse assess first?

A 24-yr-old patient who received neck radiation and has blood oozing from the neck

A patient who has ovarian cancer is crying and tells the nurse, "My husband rarely visits. He just doesn't care." The husband tells the nurse that he does not know what to say to his wife. Which problem is appropriate for the nurse to address in the plan of care?

Difficulty coping

A widowed mother of 4 school-age children is hospitalized with metastatic ovarian cancer. The patient is crying and tells the nurse that she does not know what will happen to her children when she dies. Which response by the nurse is most appropriate?

"Would you like to talk about options for the care of your children?"

During the teaching session for a patient who has a new diagnosis of acute leukemia, the patient is restless and looks away without making eye contact. The patient asks the nurse to repeat the information about the complications associated with chemotherapy. Based on this assessment, which patient problem should the nurse identify?

Anxiety

A patient has inadequate nutrition due to painful oral ulcers. Which nursing action will be most effective in improving oral intake?

Apply prescribed anesthetic gel to oral lesions before meals

A patient who is being treated for stage IV lung cancer tells the nurse about new-onset back pain. Which action should the nurse take first?

Assess for sensation and strength in the legs. (Spinal cord compression)

A patient with cancer is eating very little due to altered taste sensation. Which nursing action would address the cause of the patient problem?

Avoid giving the patient foods that are strongly disliked.

The nurse should suggest which food choice for a patient scheduled to receive external-beam radiation for abdominal cancer?

Baked Chicken

The nurse teaches a patient with liver cancer about high-protein, high-calorie diet choices. Which snack choice by the patient indicates that the teaching has been effective?

Blueberry yogurt

CAUTION

C for change in bowel or bladder habits, A for a sore that does not heal, U for unusual bleeding or discharge, T for thickening or lump in the breast or elsewhere, I for indigestion, O for obvious change to warts or moles, and N for nagging cough

External-beam radiation is planned for a patient with cervical cancer. What instructions should the nurse give to the patient to prevent complications from the effects of the radiation?

Clean the perianal area carefully after every bowel movement.

The nurse assesses a patient who is receiving interleukin-2. Which finding should the nurse report immediately to the health care provider?

Crackles at the lung bases

A patient with Hodgkin's lymphoma who is undergoing external radiation therapy tells the nurse, "I am so tired I can hardly get out of bed in the morning." Which intervention should the nurse add to the plan of care?

Establish time to take a short walk almost every day.

The nurse is caring for a patient receiving intravesical bladder chemotherapy. The nurse should monitor for which adverse effect?

Hematuria

A patient with leukemia is considering whether to have hematopoietic stem cell transplantation (HSCT). Which information should the nurse include in the patient's teaching plan?

Hospitalization is required for several weeks after the stem cell transplant.

Interleukin-2 (IL-2) is used as adjuvant therapy for a patient with metastatic renal cell carcinoma. Which information should the nurse include when explaining the purpose of this therapy to the patient?

IL-2 enhances the body's immunologic response to tumor cells.

The nurse obtains information about a hospitalized patient who is receiving chemotherapy for colorectal cancer. Which information about the patient alerts the nurse to discuss a possible change in cancer therapy with the health care provider?

Increased carcinoembryonic antigen (CEA)

A patient who is scheduled for a breast biopsy asks the nurse the difference between a benign tumor and a malignant tumor. Which answer by the nurse is accurate?

Malignant tumors may spread to other tissues or organs."

During a routine health examination, a 40-yr-old patient tells the nurse about a family history of colon cancer. Which action should the nurse take next?

Obtain more information about the patient's relatives.

An older adult patient who has colorectal cancer is receiving IV fluids at 175 mL/hr in conjunction with the prescribed chemotherapy. Which finding by the nurse is most important to report to the health care provider?

Patient has crackles up to the midline posterior chest.

After change-of-shift report on the oncology unit, which patient should the nurse assess first?

Patient who is neutropenic and has a temperature of 100.5° F (38.1° C).

A patient receiving head and neck radiation for larynx cancer has ulcerations over the oral mucosa and tongue and thick, ropey saliva. Which instructions should the nurse give to this patient?

Rinse the mouth before and after each meal and at bedtime with a saline solution.

The nurse is caring for a patient with left-sided lung cancer. Which finding would be most important for the nurse to report to the health care provider?

Serum sodium of 126 mEq/L (SIADH)

The nurse assesses a patient with non-Hodgkin's lymphoma who is receiving an infusion of rituximab (Rituxan). Which assessment finding would require the most rapid action by the nurse?

Shortness of breath

The nurse administers an IV vesicant chemotherapeutic agent to a patient. Which action is most important for the nurse to take?

Stop the infusion if swelling is observed at the site.

Which action should the nurse take when caring for a patient who is receiving chemotherapy and reports problems with concentration?

Suggest use of a daily planner and encourage adequate sleep.

When caring for a patient who is pancytopenic, which action by unlicensed assistive personnel (UAP) indicates a need for the nurse to intervene?

The UAP assists the patient to use dental floss after eating.

The nurse supervises the care of a patient with a temporary radioactive cervical implant. Which action by unlicensed assistive personnel (UAP), if observed by the nurse, would require an intervention?

The UAP stands by the patient's bed for 30 minutes talking with the patient.

The nurse is caring for a patient with colon cancer who is scheduled for external radiation therapy to the abdomen. Which information obtained by the nurse would indicate a need for patient teaching?

The patient swims several days each week.

A patient who has severe pain with terminal pancreatic cancer is being cared for at home by family members. Which finding by the nurse indicates that teaching about pain management has been effective?

The patient takes opioids around the clock on a regular schedule and uses additional doses when breakthrough pain occurs.

A hospitalized patient who has received chemotherapy for leukemia develops neutropenia. Which observation by the nurse indicates a need for further teaching?

The patient's visitors bring in fresh peaches.

The nurse reviews the laboratory results of a patient who is receiving chemotherapy. Which laboratory result is most important to report to the health care provider?

White blood cells (WBC) 2700/μL

A patient develops neutropenia after receiving chemotherapy. Which information about ways to prevent infection will the nurse include in the teaching plan?

a. Cook food thoroughly before eating. c. Avoid public transportation such as buses. e. Talk to the oncologist before having any dental work.