PN119 PrepU Chapter 50

What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents?

Be familiar with institution's policies and procedures and use them as precautionary measures.

Which of the following herbal products has the benefits of overall well being, cancer prevention, dental health and maintenance of heart and liver health as a result being loaded with antioxidants? (Choose one)

Green tea

In describing the action of alkylating agents, what would the nurse include?

React chemically with portions of RNA, DNA, and other cellular proteins.

A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory?

The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are:

cell cycle-specific.

A patient on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the patient to

notify the clinic if the stools are black or if there is evidence of blood.

A client asks the nurse what cancer cell growth is called. What would the nurse tell the client?

proliferation

A female client age 25 years is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:

use an effective contraceptive.

A parent hears the doctor using the word extravasation. The parent asks the nurse what extravasation means. What would be a correct answer?

"Extravasation is when fluid escapes from a blood vessel into the surrounding tissue."

The nurse may be asked to administer which medication to a patient to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?

Allopurinol (Zyloprim)

A client is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do?

Reassure the patient that it is a harmless and expected response to the drug.

A nurse is caring for a patient who is undergoing chemotherapy. The patient has experienced several episodes of vomiting. Which of the following activities should the nurse perform as part of ongoing assessment for signs of dehydration and electrolyte imbalances?

Measure all fluid intake and output

A patient with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the patient a better quality of life, and reduce the discomfort. What is this form of therapy called?

Palliative therapy

Which of the following classes of antineoplastic drugs stop cells in the S and G2 phase thereby causing cell division to cease? (Choose one)

Podophyllotoxins

A patient will soon begin targeted therapy as a component of her treatment plan for chronic leukemia. The nurse is conducting health education about this new aspect of the patient's drug regimen and the patient has asked about the potential side effects of treatment. How should the nurse best respond?

"Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells."

A nurse is caring for a patient who has received chemotherapy treatment. The patient has developed inflammation of the oral mucous membrane, which is affecting the nutritional aspects of care. What suggestions should the nurse provide to the patient for relief?

Provide mouth care with normal saline every 4 hours

A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the patient has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to

perform relaxation techniques after the treatments.

A client who is being treated with an antineoplastic medication for cancer is prescribed a new medication. The client is told that it is a cytoprotective agent and it is important that she allows it to be administered. She is refusing, stating that all these drugs are making everything worse, including the inside of her mouth. The medication she is supposed to get is Kepivance. What would be an appropriate response from the nurse?

"Cytoprotective agents are drugs used to protect the normal cells in your body from the chemotherapy. Kepivance helps cells in your mouth recover."

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response?

"Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue."

A patient received an injection of doxorubicin and is now observing a reddish urine. The patient states, "Do you think I am bleeding?" What is the best response by the nurse?

"The reddish urine is harmless and an expected response to the drug."

Mr. Marks is treated with cyclophosphamide. The physician is monitoring him for adverse reactions to the drug. What common adverse reaction would limit increasing of the dose?

Decreased white blood cell count

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation?

Inspect the site frequently for redness or swelling

A nurse is caring for a patient who is being treated with temozolomide in conjunction with radiation to the brain. The patient has also started prophylactic therapy to prevent Pneumocystis carinii pneumonia (PCP). Which of the following instructions should the nurse convey to this patient?

Stay away from crowds and ill individuals

A 42-year-old female with breast cancer has had a radical mastectomy. She will have radiation therapy and then begin chemotherapy. Drug therapy will consist of a combination of doxorubicin, cyclophosphamide, and paclitaxel. What will the nurse include in the teaching plan concerning the drug therapy?

Take special care when shaving or brushing her teeth.

A nurse educator who coordinates the staff education on an oncology unit is conducting an inservice on targeted therapies. What potential benefit of targeted therapies should the nurse highlight in this education session?

Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.

A 54-year-old received a diagnosis of breast cancer several weeks ago and her current treatment regimen includes tamoxifen, a cell cycle-nonspecific antineoplastic drug. What is a characteristic of a cell cycle-nonspecific drug?

The drug is effective regardless of whether a cancerous cell is proliferating.

A patient has been administered a cytotoxic antineoplastic agent. The patient is a 32-year-old female. Which of the following is the most important instruction related to teratogenicity?

The patient should not become pregnant for several months.

Prior to administering a dose of 5-FU to a patient with pancreatic cancer, the nurse is conducting the necessary drug research. The nurse is aware that 5-FU is a cell cycle-specific chemotherapeutic agent. Which statement best describes cell cycle-specific drugs?

They affect cancerous cells during a particular phase of cellular reproduction.

An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should:

administer a combination of antiemetics prior to the administration of the drug.

The mitotic inhibitors interfere with the ability of a cell to divide, and they block or alter DNA synthesis, thus causing cell death. For clients taking these drugs, the nurse should:

avoid any skin, eye, or mucous membrane contact with the drug.