MEPN 512 - Pharmacology - Exam 3
A nurse is assessing a child who has acute lymphocytic leukemia and is receiving vincristine sulfate. Which of the following findings is the nurse's priority? A. Paresthesia B. Alopecia C. Stomatitis D. Constipation
A. Paresthesia Rationale: the greatest risk to this client is neurotoxicity. Vincristine, a cell-cycle-specific chemotherapy agent, interrupts cellular reproduction at mitosis and can cause neurotoxicity. Paresthesia (numbing) of the peripheral extremities can be an early indication of neurotoxicity.
Antineoplastic agents must be given in stages because...?
This allows the tumor size to shrink in stages so that eventually the tumor will be small enough to allow the patient's body to fight off the tumor on it's own. Stages allow time for the body's immune system to recover as well.
metasized
When cancer spreads beyond its original organ
suffix for tumor
-oma
Methotrexate mechanism of action
blocks synthesis of folic acid to inhibit replication
A nurse is caring for a client who recently had chemotherapy and now has myelosuppression. Which of the following interventions should the nurse initiate? (Select all that apply.) A. Prohibit visitors from bringing fresh flowers and plants into the client's room. B. Encourage frequent visits from family and friends. C. Ensure thorough cleaning of the client's room and bathroom daily. D. Replace wound dressings every other day. E. Use dedicated equipment such as stethoscopes.
A. Prohibit visitors from bringing fresh flowers and plants into the client's room. C. Ensure thorough cleaning of the client's room and bathroom daily. E. Use dedicated equipment such as stethoscopes. Rationale: Myelosuppression is bone-marrow suppression, which puts the client at a high risk of infection after chemotherapy. Fresh flowers and potted plants can introduce microorganisms into the client's immediate environment. Due to the client's high risk of infection, the nurse should make sure the housekeeping staff clean and sanitize the client's environment daily. In addition, the nurse should utilize single-use equipment as much as possible and keep reusable equipment (e.g. stethoscopes and blood pressure cuffs) in the client's room for dedicated use by that client only.
A nurse is monitoring the laboratory values of a male client who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the nurse report to the provider? A. BUN 18 mg/dL B. Platelets 78,000/mm^3 C. Hemoglobin 14.2 g/dL D. Aspartate aminotransferase (AST) 35 units/L
B. Platelets 78,000/mm^3 Rationale: The medication can cause thrombocytopenia so the nurse should watch the platelet count of the patient. This finding indicates that the patient is at severe risk for bleeding.
What labs to check in immunocompromised patients?
Blood cells and blood cell counts
What are the two blood forming organs?
Bone marrow and lymphatic system
A nurse is teaching a client who has been taking an NSAID to treat rheumatoid arthritis. During the client's first month checkup, the provider prescribed methotrexate to be added to the medication regimen. Which of the following statements should the nurse include in the teaching about the purpose of this change in the client's medication? A. "Your current medication was not strong enough to manage this condition." B. "Once your blood levels of methotrexate are within the therapeutic range, the NSAID will be discontinued." C. "This medication was added to delay the disease progression." D. "Treating this disease with two medications will protect you from becoming treatment-resistant."
C. "This medication was added to delay the disease progression." Rationale: The nurse should inform the client that the provider prescribed methotrexate to be added to the medication regimen along with an NSAID to delay the progression of the disease and delay joint damage or deformity that can result from the disease.
