Chemotherapeutic agents

alkylating agent example

Cytoxan (cyclophosphamide)

What class of drug is Cisplantin

alkylating agent

Alkylating agents nursing implications

1 monitor for anemia and leukopenia 2 monitor for cardiac problems (Myopericarditis may occur and is a sign of a serious adverse reaction to medication) 3 Monitor for respiratory problems. (Patient may experience cough and dyspnea; medication can cause fibrosis in lungs, which would decrease functional capacity of lungs.) 4 Observe for hematuria. (Hemorrhagic cystitis may result from cyclophosphamide use secondary to continuous irritation of bladder from medication.) 5. Observe for alopecia. (All chemotherapeutic agents attack normal, fast-growing cells as well as cancer cells; hair cells are very fast growing, so hair growth stops and hair will fall out.) 6 Provide emotional support to patient and family. 7 Refer patient to ACS or other legitimate support groups 8. get a wig before hair loss requires it, to ease transition

21.) A nurse is assisting with caring for a client with cancer who is receiving cisplatin. Select the adverse effects that the nurse monitors for that are associated with this medication. Select all that apply. 1. Tinnitus 2. Ototoxicity 3. Hyperkalemia 4. Hypercalcemia 5. Nephrotoxicity 6. Hypomagnesemia

1. Tinnitus 2. Ototoxicity 5. Nephrotoxicity 6. Hypomagnesemia Rationale: Cisplatin is an alkylating medication. Alkylating medications are cell cycle phase-nonspecific medications that affect the synthesis of DNA by causing the cross-linking of DNA to inhibit cell reproduction. Cisplatin may cause ototoxicity, tinnitus, hypokalemia, hypocalcemia, hypomagnesemia, and nephrotoxicity. Amifostine (Ethyol) may be administered before cisplatin to reduce the potential for renal toxicity.

A client is receiving IV cyclophosphamide (Cytoxan). What nursing intervention is a priority for this client? A) Ensuring that the client is well hydrated B) Monitoring the white blood cell count C) Administering an antianxiety agent D) Running IV dextrose with the chemotherapy

A The client should be well hydrated while taking this drug to prevent hemorrhagic cystitis (bleeding as a result of severe bladder inflammation).

The nurse is caring for a client receiving cyclophosphamide (Cytoxan). What is a priority intervention for this client? A) Assess blood pressure hourly. B) Encourage fluids before, during, and after drug administration. C) Draw peak and trough levels. D) Keep client isolated until drug is excreted.

B Clients receiving cyclophosphamide (Cytoxan) should drink at least 2 to 3 L of fluid before, during, and after administration to prevent hemorrhagic cystitis.

The nurse is assessing a client receiving cisplatin (Platinol). What finding requires immediate action by the nurse? A) Nausea B) Elevated white count C) Increased blood urea nitrogen and creatinine D) Headache

C Cisplatin (Platinol) is known to be ototoxic, nephrotoxic, neurotoxic, and emetogenic. Increased blood urea nitrogen and creatinine could indicate nephrotoxicity.

A client is nauseated and vomiting after receiving chemotherapy. How will the nurse best intervene? A) Tell the client to avoid eating any food during chemotherapy treatments. B) There is nothing that can be done; inform the client it will pass with time. C) Maintain hydration and nutrition and administer antinausea medications. D) Use antacids to relieve the irritation to the stomach, which should stop the nausea.

C It is very important for clients undergoing chemotherapy to maintain adequate nutrition and hydration. Several antiemetic drugs are available that are very successful in controlling this side effect. The client will most likely remain nauseated even without food intake.

alkylating agent that is only one that crosses BBB

Carmustine

The nurse is caring for several clients receiving chemotherapy. What client will the nurse assess first? A) The client receiving Doxorubicin (Adriamycin) with a history of angina. B) The client receiving Fluorouracil (5-FU, Adrucil) with an elevated platelet count. C) The client taking Cyclophosphamide (Cytoxan) who is urinating 100 mL/hr. D) The client receiving Mechlorethamine (Mustargen) with pain at the IV insertion site.

D Mechlorethamine (nitrogen mustard, [Mustargen]) is a severe vesicant and can cause tissue necrosis if it infiltrates into the tissues. Pain at the IV site is an indication of possible infiltration and needs to be addressed. History of angina is a concern, because Adriamycin is cardiotoxic; however, this client is not the priority.

How does alkylating agents work

DNA synthesis inhibited, cell cannot replicate

Alkylating agents treat __, __, and ___

Hodgkin's ALL testicular cancer

Cyclophosphamide is toxic to __ and __

blood system and urinary tract

What are the SE of cytoxan (cyclophosphamide)

bone marrow suppression, neutropenia, thrombocytopenia, anemia

What are the side effects of Cisplantin?

causes kidney damage

What is Cisplantin used for?

metastatic testicular cancer, ovarian cancer and advanced bladder cancer