CHAPTER 50 Antineoplastic Drugs and Targeted Therapies

A non-English speaking client has just been diagnosed with cancer. The nurse notes that and no matter what is said, the client simply shakes his head and says "okay." How can the nurse best respond to this client?

Obtain the services of an interpreter and educational reading in the client's native language

A mother has just been told that her child has cancer and will need chemotherapy. The mother is worried about side effects. What is the nurse's best response?

"An immediate side effect of many chemotherapy agents is nausea and vomiting. There are medications that can be given prior to chemotherapy to lessen these side effects."

A female client 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 client's drug regimen and the client 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 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells?

Cancerous cells grow in an uncontrollable fashion.

A client is undergoing treatment with chemotherapy. He calls the nurse and states that his mouth hurts and there are white patches on his tongue. The nurse suspects the white patches are a symptom of what?

Candidiasis

A client on the oncology unit has begun chemotherapy with a regimen that includes bendamustine. The client has begun to experience alopecia. The nurse should prioritize assessments related to what potential nursing diagnosis?

Disturbed body image

A parent hears the health care provider 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."

A client's chemotherapy regimen has been deemed successful, but the client is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis?

Imbalanced nutrition: less than body requirements

A 39-year-old client has begun taking tamoxifen to reduce the risk of contralateral breast cancer. The client is now reporting hot flashes and dysmenorrhea. What is the nurse's best action?

Inform the client that these are likely adverse effects of drug therapy.

A nurse is presenting information at a health fair concerning cancer. When questioned about the use of green tea, the nurse would point out which potential effect of green tea?

Insomnia

A nursing instructor is conducting a class discussion on the actions of vincristine. The instructor determines the class is successful when the students correctly choose which action?

Interfere with amino acid production in the S phase

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

Review institutional policies and procedures related to chemotherapy

The nurse is administering a client's chemotherapeutic drug through a peripheral IV site, and the nurse observes that extravasation has occurred. What is the nurse's best action?

Stop the infusion and inform the health care provider immediately.

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.

The client has just been started on an alkylating agent to treat testicular cancer. What assessment finding would suggest that the client is experiencing a common adverse effect of this medication?

The client's most recent laboratory results indicate pancytopenia.

What should the oncology nurse understand when administering a cell cycle-nonspecific chemotherapeutic agent about its effect?

The drug will be effective through all phases of the cell cycle.

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

allopurinol

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.

Which herbal product has the benefits of overall well-being, cancer prevention, dental health, and maintenance of heart and liver health as a result of being loaded with antioxidants?

green tea

A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the client 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 asks the nurse what cancer cell growth is called. What would the nurse tell the client?

proliferation

A nurse is providing client education to a 35-year-old woman who has been prescribed cyclophosphamide therapy. When discussing possible hair loss, the nurse will advise the client to:

see a wig specialist.

The community health nurse is planning care for a client who will be prescribed an oral chemotherapy drug for the next several months while recovering at home. What health education topic should the nurse emphasize?

techniques for safely handling the drug

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

use an effective contraceptive.

What is the first action by the oncology nurse when observing extravasation with the client receiving vincristine?

Stop the infusion.

A client with a diagnosis of non-small-cell lung cancer is currently undergoing chemotherapy. At the encouragement of a family member, the client has announced to the nurse the intention to complement this treatment with a regimen of herbal remedies. How should the nurse respond to this client's statement?

"It's important to discuss what herbs you'll be taking with your health care provider or the pharmacist to make sure there aren't any interactions."

A client has been receiving an antineoplastic agent for a diagnosis of leukemia. The nurse will prioritize which factors on the ongoing assessment of this client? Select all that apply.

-General condition -Individual response to the drug -Any adverse reactions -Laboratory and radiographic reports

A nurse is caring for a client prescribed gemcitabine. On the morning laboratory results, the nurse discovers the following: white blood cell count 4500/mm3 and platelets 135,000/mm3. The nurse anticipates discovering which signs on the ongoing assessment?

Bloody urine

A client has been diagnosed with a brain tumor and is dealing with this diagnosis by seeking detailed information about cancer. The nurse would explain to the client that cancer is essentially a result of the disruption of what?

Cell cycle

A nurse is preparing to administer etoposide to a client. Which assessment finding that could influence dosing should the nurse prioritize in the preadministration assessment?

Complete blood count

A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?

Hodgkin lymphoma

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. The body's own immune system will kill the few cancer cells that are left.

A client is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. What effect will this regimen likely have on the client's hemostatic function?

The client's platelet count will decline.

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

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

Which agents would be considered cancer non-cell cycle specific agents?

alkylating agents

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

A nurse is assessing a client who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the client for:

leukopenia.

A nurse is caring for an elderly client who is receiving vinblastine intravenously. The nurse suspects that the client is experiencing extravasation based on assessment of which finding?

swelling at the IV site or extremity

A nurse is providing education to a client who is preparing to begin chemotherapy for the treatment of cancer. What action should the nurse encourage the client to implement to minimize the effects of chemotherapy-triggered mucositis?

thoroughly rinse the mouth often, especially before and after meals

The dosages of the chemotherapy agents that will be administered are based primarily on what client variable?

weight

A client being treated with an antineoplastic medication is being discharged from the hospital. Which of the following teaching instructions is appropriate for this client?

"You will be excreting the antineoplastic medications in your stool and urine. As a precaution, double-flush the toilet with the lid closed so the chances of contact with the drug will be lessened."

What measure protects the nurse when preparing cytotoxic drugs?

Wearing protective equipment such as gloves, mask, and gown

A health care provider has prescribed an alkylating agent for a client. The nurse anticipates administering which drug to the client?? Select all that apply.

-Chlorambucil -Cyclophosphamide -Ifosfamide

A nurse is teaching a client about the antineoplastic agent which has been prescribed. When asked about potential hair loss, which answer should the nurse prioritize?

Suggest the use of a wig or cap

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.

How can a nurse best prevent tissue damage caused by an antineoplastic extravasation?

Inspect the site frequently for redness or swelling

A client with breast cancer being treated with tamoxifen is also taking the oral anticoagulant coumadin for chronic atrial fibrillation. What is important to monitor in this client?

Prothrombin time

A nurse is caring for a client being treated with antineoplastic drugs. The client reports recently experiencing bloody urine. What complication might this client be experiencing?

Thrombocytopenia

A female client is prescribed methotrexate for meningeal leukemia. What health education should the nurse prioritize?

Use reliable forms of barrier contraception.

The nurse is providing medication education to a client with breast cancer who has been prescribed tamoxifen. How should the nurse explain the action of the drug?

slows the growth of cancer cells