Chemotherapeutic Therapy
Which statement made by the patient indicates a need for further teaching regarding doxorubicin, an antitumor antibiotic?
"I do not have to worry about infection because the drug is an antibiotic."
A nurse provides teaching to a male patient receiving chemotherapeutic drugs. Which statements made by the patient indicate an understanding of potential side effects of chemotherapeutic drugs?
"I will use a soft toothbrush to brush my teeth." "I may need to take stool softeners to avoid constipation." "I will bank some of my sperm so I still have the option of having children in the future."
A patient receiving vincristine asks why it must be given intravenously. Which response would the nurse provide to the patient?
"Oral administration has a low absorption rate."
Match the chemotherapeutic drug to its class.
Antimetabolites ---Doxorubicin Plant alkaloids ---Fluorouracil Antitumor antibiotics ----Tamoxifen Alkylating drugs ---Vincristine
A nurse is disposing of urine from a patient who is receiving chemotherapeutic drugs. Which action would the nurse take to decrease the risk for occupational exposure?
Apply a face shield.
A patient diagnosed with metastatic pancreatic cancer is prescribed fluorouracil as part of a combination regimen with oxaliplatin, leucovorin, and irinotecan. Which treatment cycle would the nurse expect fluorouracil to be repeated?
Chemotherapeutic drugs are administered in cycles followed by a rest period. Fluorouracil as part of a combination therapy is administered every 2 weeks.
The nurse preparing to administer chemotherapeutic drugs notes the patient has had a significant drop in neutrophils. The nurse would anticipate administering which product into the patient's plan of care?
Colony-stimulating factors (CSFs)
A patient with multiple myeloma received cyclophosphamide at 0900. Which time would the nurse expect the drug to peak?
Cyclophosphamide peaks in 1 to 3 hours. The drug was given at 0900; therefore 1 to 3 hours later is 1100.
Which part of the cell does fluorouracil affect during the S phase of the cell cycle?
DNA 5-FU's cytotoxic properties affect the cell's DNA during the S phase of the cell cycle. 5-FU converts to multiple active metabolites inhibiting normal cell growth.
A patient with Hodgkin's lymphoma is taking phenobarbital, a CYP2D6 inducer, along with cyclophosphamide. The nurse is concerned knowing that CYP2D6 inducers have which effect on chemotherapeutic drugs?
Decrease drug concentration CYP2D6 inducers, such as phenobarbital, can decrease the drug concentration. Inhibitors, such as amiodarone, can increase the drug concentration. Other chemotherapeutic drugs can increase cardiotoxicity and immunosuppression. Live virus vaccines can cause infection with that virus they are intended to protect.
Oral cyclophosphamide 700 mg is prescribed to a patient weighing 125 pounds. Which action would the nurse take first?
Hold the drug.
Which statement is accurate regarding tamoxifen?
It acts as both an agonist and antagonist at estrogen receptor sites.
J.W. is a 35-year-old man who was recently diagnosed with multiple myeloma. He will start treatment with cyclophosphamide and prednisone. J.W. has never been ill before and is quite nervous about starting treatment. He is newly married and wishes to have children. He also seems to be having difficulty coping with his diagnosis. His significant other is available for teaching purposes, because J.W. is not able to fully grasp the details of his treatment regimen. His significant other is very supportive and involved and attends all clinic appointments with him. Understanding J.W.'s anxiety about his cyclophosphamide treatment and wishing to facilitate as smooth a procedure as possible, the nurse plans to administer anti-emetic drug therapy. During which time frame will the anti-emetic therapy be most beneficial to J.W.?
Just before administration of the cyclophosphamide to J.W. Nausea and vomiting - Administer antiemetics just before, during, and after the chemotherapeutic drugs to decrease the severity of nausea and vomiting. Antiemetics should be given on a routine schedule, not on an as-needed basis. Minimize noise, stimulation, and odors.
Through which primary route is cyclophosphamide excreted?
Kidneys Cyclophosphamide is excreted in urine by the kidneys.
Which type of chemotherapy refers to chemotherapeutic drugs packaged in a fat globule?
Liposomal chemotherapy is treatment with chemotherapeutic drugs that are packaged inside fat globules called liposomes.
A patient is prescribed vincristine for Hodgkin's lymphoma. On further questioning, the nurse discovers the patient has plant allergies, specifically to periwinkle. Which action would the nurse take?
Notify the health care provider.
In which phase of the cell cycle do most antimetabolites affect cells?
S phase
Which location would the nurse prepare chemotherapeutic drugs before administration?
Separate work area
Which statements describe the benefits of treating cancer cells with a combination of different classes of chemotherapeutic drugs?
Therapeutic effect in all phases of cancer cells is increased. Development of drug resistance is decreased Destruction of cancer cells is increased.
A patient receiving chemotherapeutic drugs complains of mouth lesions and inability to eat or swallow. The nurse notes the patient has opioid analgesic, topical anesthetic, antiemetic, and sedative prescribed. Which drug would the nurse most likely provide?
Topical anesthetic
A patient presents with Philadelphia chromosome-negative acute lymphoblastic leukemia that has failed multiple chemotherapeutic drug therapy. Which chemotherapeutic agent would the nurse expect to administer?
Vincristine liposomal
