Pharm: Antineoplastic drugs

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."

Rituximab has been prescribed for a patient who has longstanding history of severe rheumatoid arthritis that has been minimally responsive to standard therapies. When assessing the patient prior to the start of the course of treatment, what assessment question is the nurse's priority?

"Do you have any history of heart disease or irregular heart rhythms?"

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 with chronic lymphocytic leukemia (CLL) will imminently begin a course of treatment with rituximab. In order to minimize the risk of adverse effects, what strategy for administration will be adopted?

Administering the initial doses by slow infusion while observing for adverse reactions

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?

Allopurinol (Zyloprim)

A patient is to receive high-dose bisulfan chemotherapy for the treatment of chronic myelogenous leukemia. What type of prophylaxis should the nurse anticipate administering to this patient?

An antiseizure medication to prevent seizure activity

What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents?

Be familiar with institution's policies and procedures and use them as precautionary measures.

A nurse is caring for a patient being treated with antineoplastic drugs. The patient is at risk for thrombocytopenia due to bone marrow suppression. What should the nurse monitor for in this patient?

Bloody urine

Which of the following classes of antineoplastic drugs inhibits DNA synthesis during the S phase?

Camptothecin analogs

A patient asks the nurse what a cancer cells' growth rate is called. What would the nurse tell the patient?

Cancer cell's growth rate is called proliferation.

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 melphalan, an alkylating agent, for the treatment of an ovarian tumor. The patient wants to know the action of the drug in treating the tumor. Which of the following should the nurse inform the patient?

Changes the cell to a more alkaline environment.

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 what?

Check indexes of bone marrow functioning

A medical-surgical registered nurse (RN) is requested to go to the oncology unit, which is short staffed. When the RN arrives to the unit, the oncology nurse states, "We are so short today that you are going to have to administer chemotherapy to some of the clinic patients." According to the Oncology Nurses Society (ONS), of what should the oncology nurse be aware?

Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration.

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 has been diagnosed with cancer. The physician prescribes antineoplastic drug therapy to the patient. How should the nurse explain the use of antineoplastic drugs?

Delays spread of cancer to other sites.

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

Mark, a 26-year-old man with testicular cancer, is prescribed combination chemotherapy that involves using two drugs that are effective against testicular tumors. Combination drug therapy is superior to single-drug therapy for what reason?

Higher tumor response rates

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 receiving carboplatin. The nurse would expect to administer this drug by which route?

IV

A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?

Non-Hodgkin's lymphoma

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

Knowing there are multiple causes of malignancies, two significant causes are environmental factors and genetic factors. Gene mutations have a direct connection to the proliferation of potentially neoplastic cell development. The normal growth-regulating genes that are present in all cells are called:

Proto-oncogenes.

A nurse is caring for a patient who has received chemotherapy treatment. The patient has developed inflammation of the oral mucous membrane, which is affecting the nutritional aspects of care. What suggestions should the nurse provide to the patient for relief?

Provide mouth care with normal saline every 4 hours

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 nurse on an oncology unit is aware of the need to assess for adverse effects in patients who are being treated with rituximab. The risks of adverse effects are highest at what point during the course of treatment?

Shortly after the initiation of the first infusion of rituximab

The patient receiving a first infusion of paclitaxel complains of chills and dyspnea. The oncology nurse assesses the patient and observes facial flushing, wheezing, and extreme anxiety. What is the priority intervention by the nurse?

Stop the infusion.

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 nurse is caring for an elderly patient who is being administered vinblastine. The nurse is monitoring the IV site for extravasation. Which of the following are signs of extravasation that the nurse should be aware of?

Swelling at the IV site or extremity

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 her teaching plan concerning the drug therapy?

Take special care when shaving or brushing her teeth

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 taking high doses of cyclophosphamide is exhibiting muscle cramps and confusion and reports headaches. The nurse assesses the laboratory tests and notices the sodium level is low. What does the nurse determine may be occurring with this patient?

The patient is exhibiting signs of syndrome of inappropriate antidiuretic hormone caused by the high dose of cyclophosphamide.

A female client develops hepatotoxicity from the antineoplastic drugs that she is receiving. She has abnormal levels of AST, ALT, and bilirubin. The physician may not decrease the drugs, for what reason?

These findings do not indicate decreased ability to metabolize drugs.

T/F An adverse effect of tamoxifen therapy involves menopausal symptoms.

True

A nurse is caring for a patient who is at risk for erythema during antineoplastic drug therapy. What should the nurse suggest to this patient?

Wear loose protective clothing.

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 is caring for a patient newly diagnosed with a primary brain tumor. The patient asks the nurse where his tumor came from. What would be the nurse's best response?

Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue.

Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by

slowing the infusion.

A patient has been scheduled to begin treatment with rituximab for non-Hodgkin's lymphoma. The nurse who will administer this drug should understand that it targets

specific antigens on the surface of malignant B cells.

A patient who has been taking high-dose cyclophosphamide therapy has had sterile hemorrhagic cystitis. What measures can the oncology nurse take to reduce the risk of recurrence?

• Administer mesna as ordered. • Prehydrate the patient orally and intravenously (IV) with 2 L of normal saline. • Monitor urine output.

A patient undergoing antineoplastic drug therapy is administered an alkylating drug. The patient is also administered an aminoglycoside as an anti-infective agent. Which of the following interactions of the alkylating drug with the aminoglycoside should the nurse assess the patient for?

Increased risk of nephrotoxicity

A nurse is caring for a patient undergoing treatment with plant alkaloids for cancer. The patient is also administered warfarin for a history of atrial fibrillation. Which of the following is an interactive effect of the two drugs which the nurse should monitor the patient for?

Increased risk of prolonged bleeding

Which of the following nonpharmacological interventions may prevent cystitis caused by cyclophosphamide (Cytoxan)?

Keeping well hydrated

A nurse is caring for a patient who is undergoing chemotherapy. The patient has experienced several episodes of vomiting. Which of the following activities should the nurse perform as part of ongoing assessment for signs of dehydration and electrolyte imbalances?

Measure all fluid intake and output

Which agent would the nurse expect to be administered orally?

Methotrexate

Which of the following would the nurse identify as an antineoplastic antibiotic?

Mitomycin

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.