Chapter 56: Drugs That Are Cell Cycle-Specific

A mother has just been told that her child has cancer and will need chemotherapy. The mother is worried about side effects. What is the nurse's best response? "An immediate side effect of many chemotherapy agents is nausea and vomiting. There are medications that can be given prior to chemotherapy to lessen these side effects." "There are no long-term side effects from chemotherapy. Infertility and organ failure issues seen in clients after chemotherapy are coincidental." "During the treatment cycle, bone marrow suppression is a common side effect, so it is important that the child goes back to school and is involved in all activities, such as football." "Children do not have side effects of chemotherapy because their immune systems are not fully developed until after 12 years of life."

"An immediate side effect of many chemotherapy agents is nausea and vomiting. There are medications that can be given prior to chemotherapy to lessen these side effects."

A young man asks the nurse about the goal of the cancer therapy his mother is receiving. What would be the nurse's best response? "The goal is to keep the cancer cells from spreading all over your mother's body." "The goal is to control the spread of the cancer." "The goal is to limit the cancer cells so the immune system can respond without causing too much toxicity to your mother." "The goal is to kill the cancer cells so your mother will be well again."

"The goal is to limit the cancer cells so the immune system can respond without causing too much toxicity to your mother."

Which patient receiving 5-FU therapy has the potential for severe neurotoxicity? A 32 year old with psoriasis A 52-year-old male with myelosuppression A 29-year-old female with familial pyrimidinemia A 54 year old with a history of coronary artery disease

A 29-year-old female with familial pyrimidinemia

Ms. Kallie is admitted to the hospital from the physician's office with a headache, change in level of orientation, and jerking eye movements. Ms. Kallie is being treated with 5-fluorouracil (5-FU). What is she most likely to be suffering from? Drug overdose Ineffective treatment Cardiotoxicity Acute cerebellar syndrome

Acute cerebellar syndrome

Mr. Melika is treated with high-dose chemotherapy after a radical prostatectomy. What term would best describe this type of therapy? Induction therapy Adjuvant therapy Consolidation therapy Maintenance therapy

Adjuvant therapy Adjuvant therapy: This therapy involves a short course of high-dose drug therapy (usually with a combination of drugs) administered after radiation or surgery to destroy residual tumor cells or micrometastases and prevent recurrence.

What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents? Only administer chemotherapy agents that are not toxic. Be familiar with institution's policies and procedures and use them as precautionary measures. Attend in-service education. Recognize the dangers of administering chemotherapeutic agents.

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

A patient with leukemia receiving cytarabine (Ara-C) has developed a toxicity called chemical keratitis. What medication can the oncology nurse anticipate using for treating this? Prostaglandin analogs Dexamethasone eye drops Decongestant eye drops Neosporin ophthalmic solution

Dexamethasone eye drops

No cancer cells have been identified that can remain dormant for more than 2 years. False True

False

A patient has been administered methotrexate, which is a purine antagonist used to treat a rapidly growing tumor. The patient develops stomatitis. What is the priority nursing diagnosis for a patient suffering from stomatitis? High risk for infection Imbalanced nutrition Impaired skin integrity Increased bleed risk

Impaired skin integrity

The nurse has been administering interleukins to a client. What change in the client's health status would indicate successful therapy? Decrease in inflammation Maintenance of adequate circulating platelets Decrease in number of natural killer cells Increase in the number of lymphocytes

Increase in the number of lymphocytes

A patient is beginning a course of chemotherapy for the treatment of chronic lymphocytic leukemia. To what is the start of this therapy referred? Palliative therapy Induction therapy Consolidation therapy Maintenance therapy

Induction therapy

A patient with bladder cancer is to have intravesicular instillation of a chemotherapeutic agent into the bladder. What is a priority intervention of the oncology nurse? Attache the tubing to suction. Insert a Foley catheter. Keep the catheter unclamped. Assist the physician to place a thoracotomy tube.

Insert a Foley catheter.

The oncology nurse is preparing to administer 5-fluorouracil to a patient with colon cancer. To potentiate the action of the 5-fluorouracil, what other medication may be administered with the drug? Hydroxyurea Paclitaxel Etoposide Leucovorin

Leucovorin

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? M G0 G1 S

M

The patient in remission is receiving a low-dose cytotoxic drug so that there will be a delay in the regrowth of residual cancer cells. What is this form of therapy called? Neoadjuvant Maintenance Intensification Palliative

Maintenance

The oncology nurse is preparing to reconstitute gemcitabine (Gemzar). With what solution should the nurse prepare the medication? Bacteriostatic water Normal saline Dextrose and water Lactated Ringers

Normal saline

A patient with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the patient a better quality of life, and reduce the discomfort. What is this form of therapy called? Adjuvant therapy Consolidation therapy Palliative therapy Neoadjuvant therapy

Palliative therapy

Which of the following classes of antineoplastic drugs are considered cell cycle-specific? Select all that apply: Akylating agents Plant alkaloids Antimetabolites Retinoids Antineoplastic antibiotics

Plant alkaloids Antimetabolites

What is the first priority action of the oncology nurse when there is a spill of a chemotherapeutic agent? Pick up glass fragments with a scoop. Wear an approved respirator. Post a sign to warn people away from the exposed area. Rinse the absorbed spill area with clean water. Repeat the washing and rinsing.

Post a sign to warn people away from the exposed area.

The oncology nurse is preparing a chemotherapy agent and not wearing goggles. Some medication splashes in the eyes. What is the priority action for the eye exposure? Have a co-worker take the nurse to the emergency department. Place drops in the eyes for the discomfort and then irrigate with water. Cover the eyes with sterile gauze. Rinse with copious amounts of water for no fewer than 15 minutes.

Rinse with copious amounts of water for no fewer than 15 minutes.

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? Testicles Ovaries Skin Breast

Skin

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? Continue the infusion and administer diphenhydramine 50 mg, intravenously. Continue the infusion and administer epinenphrine 0.3 mg subcutaneously. Place the patient in supine position. Stop the infusion.

Stop the infusion.

A patient receiving chemotherapy complains of a metallic taste in the mouth. What suggestions by the oncology nurse may help to minimize this problem? Use an antifungal troche. Use an astringent mouthwash. Brush teeth before and after chemotherapy. Suck on hard candy.

Suck on hard candy.

The cell cycle consists of 5 phases. Each cell goes through these phases. How would cell phase G1 be defined? Protein synthesis occurs. The cell increases in size and synthesis of RNA. The resting phase of the cell Mitosis occurs.

The cell increases in size and synthesis of RNA.

A client with alopecia should cover the head if the client will be exposed to extremes of temperature. False True

True

A patient has come to the short-stay unit to receive their IV chemotherapy. What action by the nurse would be the least beneficial to the patient? Using an infusion pump to administer the medication Premedication the patient as ordered Starting the IV in a large, distal vein Checking the IV line frequently

Using an infusion pump to administer the medication

Which of the following is an example of an antineoplastic drug that interferes with amino acid production in the S phase and the formation of microtubules in the M phase? Etoposide (Toposar) Irinotecan (Camptosar) Teniposide (Vumon) Vinblastine (Velban)

Vinblastine (Velban)

The nurse should exercise caution when administering antimetabolites to a patient with: hypertension. seizure activity. diabetes mellitus. bone marrow suppression.

bone marrow suppression.

The oncology nurse understands that chemotherapeutic agents are most effective during a particular phase of the cell cycle. This means the agents are: cell cycle-specific. cell cycle-nonspecific. cell targeting. growth fraction.

cell cycle-specific.

Many times a combination of antineoplastic medications are used to: decrease the development of cell resistance. increase the length of treatment. increase the quantity of each medication used. decrease the side effects of each medication.

decrease the development of cell resistance.

The nurse reviews the plan of care for a patient receiving antineoplastic therapy. The nurse notes a nursing diagnosis of risk for infection. Which adverse effect would the nurse expect the patient to exhibit? alopecia dehydration pancytopenia gastrointestinal toxicity

pancytopenia

A client asks the nurse what cancer cell growth is called. What would the nurse tell the client? pleomorphism neoplasm anaplasia proliferation

proliferation

A nurse on the oncology unit is caring for a client with an astrocytoma. The client has just been told that the tumor is growing very fast. The client asks the nurse how these tumors grow. What would be the nurse's best response? "Brain tumors grow by invading the surrounding grey matter." "Brain tumors spread down the spinal cord." "Brain tumors infiltrate the surrounding tissue." "Brain tumors grow by invading the surrounding white matter."

"Brain tumors infiltrate the surrounding tissue."

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? Because there is a critical shortage of oncology nurses in the unit, it is within the scope of practice for the RN to administer the chemotherapy. The oncology nurse should be aware that he or she must watch the RN administer the chemotherapy. The oncology nurse should be aware that he or she may delegate chemotherapy to another nurse as long as the oncology nurse is in the department. Chemotherapy should be administered by RNs who have successfully completed a course in chemotherapy administration.

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

After the instillation of an intrapleural chemotherapeutic agent, what should the oncology nurse do for the medication to reach optimal absorption? Infuse the medication, allow it to dwell, and then drain the solution. Clamp the tube for 18 hours and then connect to suction. Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours. Clamp the tube for 1 hour and unclamp for 1 hour.

Clamp the tube and reposition the patient every 10 to 15 minutes for 2 hours. Following installation of the chemotherapeutic agent, clamp tubing and reposition the patient every 10 to 15 minutes for 2 hours. Attach tubing to suction for 18 hours. Assess the patient for pain, fever, or anxiety and provide analgesic, antipyretic, and emotional support.

A client with renal cancer is prescribed aldesleukin. What action should then nurse perform? Assess whether the client can sit upright after taking oral medications Ensure the client has adequate intravenous access Assess the integrity of the client's oral mucosa Ensure that the client is able to adhere to the prescribed treatment

Ensure the client has adequate intravenous access

A nurse is administering an antineoplastic extravasation occurs. How can the nurse best prevent tissue damage caused by extravasation? Administer through a hand vein, if possible Use an infusion pump Inspect the site frequently for redness or swelling Infuse into proximal veins whenever possible

Inspect the site frequently for redness or swelling

The patient taking hydroxyurea states that she is having difficulty swallowing the pills. What suggestions by the oncology nurse can help minimize this problem? Mix the capsules with applesauce, water, or juice and swallow in liquid form. Administer the medication at the outpatient clinic intravenously. Switch the treatment regimen to one that the patient can tolerate. Suck on an ice cube to numb the pharynx prior to swallowing the medication.

Mix the capsules with applesauce, water, or juice and swallow in liquid form.

A patient is having an intrapleural instillation of a chemotherapeutic agent. What does the oncology nurse need to monitor prior to instillation of the medication? Monitor for signs and symptoms of bleeding. Assess the patient for a headache. Monitor for signs and symptoms of infection. Monitor for complete drainage from the pleural cavity before instillation of the drug.

Monitor for complete drainage from the pleural cavity before instillation of the drug.

The nurse is caring for a patient who is receiving a combination of antineoplastic agents. The patient will most likely lose her hair. Why would the nurse suggest that she get a wig or use appropriate head cover? People may be uncomfortable seeing her bald head The hair will likely grow back if the head is covered at all times Most of the heat is lost through the head and it is important to cover it during extremes in temperature Her self-esteem will be better if the head is covered

Most of the heat is lost through the head and it is important to cover it during extremes in temperature

Mr. Mass has been diagnosed with lung cancer. The physician orders chemotherapy prior to the surgery to reduce the tumor burden. What strategy relates to chemotherapy administered to reduce the tumor burden before surgery or radiation, to improve the outcomes of these methods? Palliative therapy Induction therapy Consolidation therapy Neoadjuvant therapy

Neoadjuvant therapy Neoadjuvant therapy relates to chemotherapy administered to reduce the tumor burden before surgery or radiation, to improve the outcomes of these methods.

A Hispanic client has just been diagnosed with cancer. The nurse notes that the client does not speak English very well, and no matter what the nurse says the client simply shakes his head and says "okay." How can the nurse best respond to this client? Continue to speak English to the client regarding the client's diagnosis. Give the client lots of literature regarding the client's diagnosis so that the client can read it at his leisure. Speak English very slowly and loudly so that the client can understand better what the nurse is saying. Obtain the services of an interpreter to translate the information to the client and obtain literature that is written in Spanish.

Obtain the services of an interpreter to translate the information to the client and obtain literature that is written in Spanish.

A client asks the nurse why he has to have several courses of a chemotherapy drug instead of just one dose. The nurse states that it is based on the cell kill theory. Which of the following statements describes the cell kill theory? The cell kill theory is based on the premise that one dose of a chemotherapy drug will kill all the cancer cells if enough of the medication is given to a client. The cell kill theory describes the ways that different chemotherapy medications work to kill both healthy and cancerous cells within the human body. The cell kill theory describes the phenomenon that occurs during the life cycle of a cancer cell as it is treated with a chemotherapy medication. The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

The cell kill theory describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. After several rounds of chemotherapy, nearly all of the cancer cells are killed and the body's immune system will kill the few cancer cells that are left.

A female patient prescribed methotrexate for meningeal leukemia is asking the nurse about adverse effects of the drug. What would the nurse tell this patient should be avoided while taking methotrexate? pregnancy aerobic exercise alcohol smoking

pregnancy