PHARM. Chapter 14
A patient 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 patient's drug regimen and the patient 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 parent hears the doctor talking and uses the word extravasation. The parent comes to the nurse to ask what extravasation means. What would be a correct answer by the nurse?
"Extravasation is when fluid escapes from a blood vessel into the surrounding tissue."
A female client is receiving L-asparaginase. She is at the end of her chemotherapeutic course and is concerned because her liver function tests are abnormal. What is an appropriate response by the nurse?
"Liver impairment usually subsides when chemotherapy is complete."
A patient is diagnosed with a brain tumor. He is told the cancer cells proliferate. The patient asks the nurse what this means. What is the nurse's best response?
"The proliferation is the growth of cancer cells and the rate of growth."
A patient received an injection of doxorubicin and is now observing a reddish urine. The patient states, "Do you think I am bleeding?" What is the best response by the nurse?
"The reddish urine is harmless and an expected response to the drug."
A patient having chemotherapy is losing her hair. She asks the nurse if her hair will come back as it originally was. What is the best response by the nurse?
"Your hair will grow back, but the new hair may be a different color or texture."
The nurse may be asked to administer which of the following medications to a patient to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? (Choose one)
Allopurinol (Zyloprim)
A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect?
Cardiotoxicity
The oncology nurse understands that he or she is administering chemotherapeutic agents that are most effective during a particular phase of the cell cycle. To what is this referred?
Cell cycle-specific
A patient has been prescribed treatment with antineoplastic drugs, which have a depressing effect on the bone marrow. What pre-administration assessment should the nurse perform for this patient with respect to the depressing effect of the bone marrow?
Complete blood count
A patient who is receiving methotrexate is also receiving leucovorin. The nurse understands that this drug is being given for which reason?
Counteract effects of methotrexate
A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of possible adverse effects of the drug, the nurse will instruct the patient to do which of the following?
Drink a lot of water
No cancer cells have been identified that can remain dormant for more than 2 years.
False
A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include?
Hormonal therapies
A patient is to receive goserelin as treatment for advanced prostatic cancer. The nurse would expect this drug to be ordered for administration by which route?
Implant
A nurse is administering an antineoplastic that can cause necrosis and cellulitis if extravasation occurs. Which intervention would be most appropriate to prevent this from occurring?
Inspecting site for redness or swelling
A patient is diagnosed with ovarian cancer. Why is this cancer considered to be an aggressive form?
It is fed by the hormones produced by the ovaries.
A male patient has been on long-term bicalutamide (Casodex) therapy. In order to assess adverse effects of the drug therapy, the nurse will closely monitor which of the following?
Liver function
Which of the following would the nurse identify as an antineoplastic antibiotic?
Mitomycin
An elderly man has been admitted to a residential care facility and the nurse has conducted a medication reconciliation. The man has taken numerous drugs in the past, including a course of bicalutamide (Casodex) several years earlier. The nurse recognizes this drug as being an antiandrogen and is consequently justified in presuming that the man has a history of what disease?
Prostate cancer
Ms. Nicole is prescribed doxorubicin drug therapy for carcinoma of the breast. On the second day of drug therapy, she calls in to report reddish urine. What should the nurse do?
Reassure the patient that it is a harmless and expected response to the drug.
A nurse administers ondansetron to a client receiving chemotherapy for which reason?
Reduce vomiting
A patient has just received her first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen
Risk for Infection related to bone marrow suppression
A patient with non-Hodgkin's lymphoma (NHL) will be starting a course of doxorubicin shortly. When planning this patient's care, what nursing diagnosis should the nurse prioritize?
Risk for Infection related to suppressed bone marrow function
A client develops leukopenia after receiving chemotherapy. Which nursing diagnosis would be most appropriate?
Risk for infection
Mr. Potts is treated with cisplatin therapy. The major side effect of this medication is severe nausea and vomiting that occur within 1 to 4 hours after treatment and usually lasts for 24 hours. Identify the drug plan that is most effective in treating acute emesis from cisplatin therapy.
Serotonin receptor antagonists
When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through the cell cycle quickly. The nurse would identify the cells of which of the following as an example?
Skin
A patient is to start with chemotherapy. The patient is worried about going bald in the course of the treatment. How can the nurse assist the patient in being comfortable with his or her body image?
Suggest the use of a wig or cap.
A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug?
Tamoxifen
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 patient is administered mesna (Mesnex) to prevent cystitis induced by ifosfamide. How will this medication combination prevent cystitis?
The medication combines with the metabolite of ifosfamide.
A female client age 25 years is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to do which of the following?
Use an effective contraceptive.
The chemotherapy nurse is preparing to administer cytotoxic chemotherapy medications for administration. Which of the following measures protects the nurse from harm related to the chemotherapy?
Wearing protective equipment
An adult patient who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin. The nurse has conducted patient teaching about the possibility of nausea and vomiting. In order to reduce the patient's risk of severe nausea, the nurse should
administer a combination of antiemetics prior to the administration of the drug.
A 63-year-old male patient has just begun treatment with IV paclitaxel. About 10 minutes into the infusion, the nurse becomes concerned about a possible anaphylactic reaction to the drug because the patient is experiencing
dyspnea.
A 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may
promote bleeding.
A nurse is providing patient education to a 35-year-old woman who has been prescribed cyclophosphamide therapy. When discussing possible hair loss, the nurse will advise the patient to
see a wig specialist.
Cancer is considered the second leading cause of death in the United States.
true
The nurse is preparing a client who will begin chemotherapy in a few days. The nurse knows that which are the most common adverse effects encountered by most clients who receive chemotherapy? (Select all that apply.)
• Alopecia • Thrombocytopenia • Anemia
Biologic targeted antineoplastics are being used more frequently to increase anticancer efficacy and decrease the adverse effects of traditional cytotoxic chemotherapy. They address which mechanisms of action in cancer development? Select all that apply.
• Failure of the immune system to eliminate mutant, premalignant, and malignant cells. • Failure of the growth-regulating mechanisms to control the proliferation of mutant, premalignant, and malignant cells.
