Antinoplastic PrepU
A postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug? Tamoxifen Bleomycin Cyclophosphamide Cisplatin
Anti-estrogens are first-line therapy for treating breast cancer in postmenopausal women. Tamoxifin is the most widely recognized anti-estrogen.
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 Risk for Impaired Skin integrity related to cytotoxic effects of doxorubicin Risk for Imbalanced Nutrition: More Than Body Requirements related to metabolic effects of doxorubicin Risk for Ineffective Airway Clearance related to decreased neurological function
Because doxorubicin suppresses bone marrow function, the patient is at risk of leukopenia and subsequent infection. Impaired skin integrity is less likely and airway clearance will not normally be affected. Nutritional deficit, not excess, is common.
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. bradycardia. hypertension. increased body temperature.
Dyspnea, hypotension, tachycardia, wheezing, and chest pain are manifestations of anaphylactoid reaction. This hypersensitivity reaction usually occurs during the first 20 minutes of the infusion and happens on the first or second exposure to the drug. Increased body temperature is not associated with an anaphylactoid reaction.
Which agent would the nurse expect to be administered orally? Cytarabine Fluorouracil Gemcitabine Methotrexate
Methotrexate is absorbed well from the gastrointestinal (GI) tract and can be administered orally. Cytarabine, fluorouracil, and gemcitabine must be administered parenterally because they are not absorbed well from the GI tract.
A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? Inspect the site frequently for redness or swelling Infuse into proximal veins whenever possible Administer through a hand vein, if possible Use an infusion pump
Site inspection is a major intervention for preventing extravasation. Distal veins should be used. Small veins in the hand or wrist should be avoided. An infusion pump should be avoided because it can continue to administer the drug under pressure, leading to severe extravasation.
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 which cells as an example? Skin Breast Testicles Ovaries
Skin cells proceed very rapidly through the cell cycle. Breast cells proceed very slowly through the cell cycle. Cells of the testicles proceed very slowly through the cell cycle. The cells of the ovaries proceed very slowly through the cell cycle.
A client is receiving tamoxifen. Which adverse effect would be most specific to the action of this drug? bone marrow suppression gastrointestinal toxicity hepatic dysfunction menopausal effects
Tamoxifen belongs to the group of drugs that are hormones or hormone modulators. These agents are hormone specific. This drug competes with estrogen at the receptor sites, ultimately blocking estrogen. The adverse effects specific to this action would involve menopause-associated effects. Bone marrow suppression, GI toxicity, and hepatic dysfunction occur with this drug, but these are not specific to the drug's action.
A female client is ending an extensive chemotherapeutic regimen that included cytotoxic antineoplastic drugs. What does the nurse understand about bone marrow toxicity in this client? It is a common adverse effect of her treatment. It is a rare side effect of the chemotherapy. It will cause the health care provider to increase the dose of chemotherapeutic medications. It will ultimately lead to death.
Traditional cytotoxic antineoplastic drugs are nonselective in their effect on proliferating cells; therefore, bone marrow toxicity is a common adverse effect of many cytotoxic drugs. These drugs kill the same fraction of cells with each cycle of chemotherapy treatment; repeated cycles of cytotoxic drugs potentially lower the number of cancer cells to a level where a person's immune responses are able to take over and destroy the remaining cancer cells.
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 achieve the therapeutic benefits of traditional chemotherapy with no risk of adverse effects. Targeted therapies have the potential to provide prophylactic protection against neoplasia in high-risk individuals. Targeted therapies are significantly more cost-effective than traditional chemotherapeutic drugs. Targeted therapies have the potential to damage cancerous cells while leaving normal body cells less affected.
By focusing on molecular and cellular changes that are specific to cancer, targeted cancer therapies may be more effective than current treatments and less harmful to normal cells so that they may produce fewer adverse effects. However, adverse effects are not wholly absent. These drugs are not normally used as cancer prophylaxis and many are prohibitively expensive.
A parent hears the health care provider using the word extravasation. The parent asks the nurse what extravasation means. What would be a correct answer? "Extravasation is when blood vessels are severed." "Extravasation is when fluid is pooled in one part of the body." "Extravasation is when fluid escapes from a blood vessel into the surrounding tissue." "Extravasation is a disease that causes shock."
Extravasation is the escape of fluid from a blood vessel into surrounding tissues. Blood vessels are not cut for this to happen. Edema is when fluid is pooled in one area of the body. Extravasation is not a disease. In some types of shock, extravasation occurs.
A patient is diagnosed with ovarian cancer. Why is considered to be an aggressive form of cancer? It is fed by calcium in women who take estrogen. It is fed by the hormones produced by the ovaries. The younger the client, the more aggressive the form. The woman has a supply of testosterone from the ovaries.
Factors that influence the growth of tumors include blood and nutrient supply, immune response, and hormonal stimulation. The client's tumor is fed by the hormones produced by the ovaries. The tumor is not fed by calcium. A younger client may have more aggressive forms of cancer based on the increased hormone production in the younger client. The client is not producing testosterone from the ovaries.
A nurse is performing discharge teaching with a client who will soon return home. The client will continue taking imatinib for the foreseeable future, and the nurse is teaching the client about the safe administration of this drug. How should the nurse instruct the client to take imatinib? With food and a large glass of water On an empty stomach Thirty minutes before breakfast and in the early evening, at least 2 hours after dinner With a glass of grapefruit or cranberry juice
Imatinib should be taken with food and a large glass of water.
A client develops leukopenia after receiving chemotherapy. Which nursing diagnosis would be most appropriate? Disturbed body image Imbalanced nutrition Risk for infection Deficient fluid volume
Leukopenia indicates that the number of white blood cells is low. Subsequently, the client is at risk for infection because adequate white blood cells are not present to mount a response. Disturbed body image might result from alopecia or significant weight loss. Imbalanced nutrition may be appropriate for the client who is unable to consume adequate calories or nutrients secondary to nausea and vomiting. Deficient fluid volume would be appropriate for a client who is experiencing an increase in fluid loss through vomiting or diarrhea or who is unable to consume adequate amounts of fluid by mouth due to nausea or vomiting.
A client with a diagnosis of bladder cancer is started on a chemotherapeutic regimen that includes three agents. What is the rationale for using multiple antineoplastic agents? The use of three agents decreases the development of cell resistance. The use of three agents increases the length of treatment. The use of three agents increases the quantity of one of the agents. The use of three agents decreases the adverse effects.
Most chemotherapy regimens involve a combination of drugs with different actions at the cellular level, which destroys a greater number of cancer cells and reduces the risk of the cancer developing drug resistance. The rationale for using multiple antineoplastic agents is not accurately explained by any of the other options.
The purpose of antineoplastic drugs is to affect cells that rapidly divide and reproduce; however, the adverse effects produced by antineoplastic drugs result from their systemic use, which exposes nonmalignant cells in the body that are rapidly dividing and reproducing. Which is not an example of a rapidly dividing and reproducing cell in the body? nerve cell bone marrow cell hair follicle cell oral mucosal cell
The normal cells that line the oral cavity and GI tract and the cells of the gonads, bone marrow, hair follicles, and lymph tissues are rapidly dividing cells that are subject to the effects of antineoplastic drugs and are the cause of adverse effects of antineoplastic drugs. Nerve cells are slow reproducing.
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? Forewarn about hair loss. Explain it is not life-threatening. Suggest the use of a wig or cap. Explain that hair preserves body heat.
The nurse can assist the patient in being comfortable with his or her body image by suggesting that the patient use a wig or cap until the hair grows back. The nurse should forewarn about hair loss to prepare the patient for the outcome of the treatment. The nurse should explain that hair preserves body heat and loss of hair is not life-threatening, and this will put the patient at ease during treatment.