chapter 50 prepU
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
The nurse is reviewing the lab values for a client who has myelosuppression post chemotherapy treatment. The nurse is likely to see which abnormal values for this client?
Decreased thrombocytes
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
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 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."
An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing this client's laboratory work, the nurse should consequently prioritize assessment of what?
BUN and creatine
A client has been diagnosed with leukemia. Which alkylating agent is the only one that can be used for both acute and chronic leukemia?
Cyclophosphamide
After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example?
Doxorubicin
A client with leukemia is being treated with a combination of antineoplastics, including methotrexate. The client's most recent laboratory results indicate the client is experiencing bone marrow suppression. What is the nurse's priority action?
Ensure that all staff and visitors adhere to infection control precautions.
A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?
Hodgkin lymphoma
A client is being treated on the oncology unit and has developed worsening adverse effects over the past several days of chemotherapy. Administration of filgrastim may aid in achieving what desired outcome?
Increased leukocytes
The client is taking ifosfamide as a component of cancer treatment, and the client's oncologist has just added mesna to the client's medication regimen. How should the nurse best assess for the therapeutic effect of mesna?
Monitoring the client's urine output for signs of hematuria
A client has chosen to be placed on hospice. Which is acceptable chemotherapy for a client on hospice?
Palliative chemotherapy
A client asks the nurse what cancer cell growth is called. What would the nurse tell the client?
Proliferation
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.
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 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 bad 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
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.
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.
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 51-year-old female patient has been receiving doxorubicin for metastatic breast cancer. Her medical record indicates she has cardiomyopathy and a cumulative dose of 300 mg/m2 of doxorubicin. Which measure would help limit the severity of the cardiomyopathy in this client?
The use of dexrazoxane in conjunction with doxorubicin
The nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. How should the nurse best explain the need?
Time is needed to replace many of the healthy body cells killed by chemotherapy.
The nurse is caring for a client who is receiving a combination of antineoplastic agents. The client has been told that alopecia is likely to occur, and the client is tearful and distraught about this. What is the nurse's best response?
Validate the client's sense of impending loss and offer guidance for getting a wig.
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.
The nurse is caring for a client who has leukemia. What aspect of this client's health status should the nurse prioritize when confirming the appropriateness and dosing of antimetabolites?
bone marrow suppression
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 an antineoplastic agent for a 9-year-old cancer patient. Before administering an antineoplastic agent, the nurse's most important action should be to:
check indexes of bone marrow functioning.
Many times a combination of antineoplastic medications are used to:
decrease the development of cell resistance
A male client on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the client to:
notify the clinic if the stools are black or if there is evidence of blood.
The nurse is caring for a client whose current antineoplastic regimen includes bicalutamide. The nurse should anticipate what additional aspect of this client's cancer treatment?
prostatectomy
A recent nursing graduate is receiving special training to become certified in handling and administering chemotherapy drugs. This special training is necessary because of what nursing diagnosis among clients receiving chemotherapy?
risk for injury related to chemotherapy
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 and cancer cells
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.
