PREP U 14
A patient newly diagnosed with CML has been prescribed treatment with imatinib. The patient asks the nurse how imatinib works. What would be the nurse's best response?
"Imatinib inhibits the enzyme created by the Philadelphia chromosome abnormality in CML."
Chlorambucil has been ordered for a patient with Hodgkin's disease. The patient's son asks the nurse what this drug does. What would be the nurse's best answer?
"It is palliative chemotherapy used to relieve pain associated with tumor."
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 client received an injection of doxorubicin and is now observing a reddish urine. The client reports blood in the urine to the nurse. How should the nurse respond?
"The reddish urine is an expected response to the drug."
Monoclonal antibodies were developed to facilitate one's immune system to fight proliferation of cancer cell through various mechanisms of action. What infusion premedications are indicated to decrease infusion reactions?
Acetaminophen Diphenhydramine
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 client has been diagnosed with leukemia. Which alkylating agent is the only one that can be used for both acute and chronic leukemia?
Cyclophosphamide
A client has been diagnosed with cancer. The health care provider prescribes antineoplastic drug therapy to the client. How should the nurse explain the use of antineoplastic drugs?
Delays spread of cancer to other sites
A patient with advanced renal cell cancer is undergoing a course of treatment that includes sunitinib (Sutent). What diagnostic test should be performed prior to and during the administration of this drug?
ECG
A male client is receiving parenteral cytotoxic medications in the home. Adjunct therapy may include what substance?
Erythropoietin
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 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
A patient is receiving carboplatin. The nurse would expect to administer this drug by which route?
Intravenous
Which nonpharmacological intervention may prevent cystitis caused by cyclophosphamide (Cytoxan)?
Keeping well hydrated
Which would the nurse identify as an antineoplastic antibiotic?
Mitomycin
A client with a pancreatic tumor will be starting on chemotherapy to decrease the size of the tumor, give the client a better quality of life, and reduce discomfort. What is this form of therapy called?
Palliative therapy
Which of the following classes of antineoplastic drugs are considered cell cycle-specific? Select all that apply:
Plant alkaloids Antimetabolites
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
A nurse is caring for a client who has received chemotherapy treatment. The client has developed inflammation of the oral mucous membrane, which is affecting the nutritional aspects of care. What suggestions should the nurse provide to the client for relief?
Provide mouth care with normal saline every 4 hours
A client has been prescribed cabazitaxel 25 mg/m2 PO every three weeks for the treatment of prostate cancer. What is the nurse's priority response to this prescription?
Question the prescriber about the route
What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents?
Review institutional policies and procedures related to chemotherapy
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 the teaching plan concerning the drug therapy?
Take special care when shaving or brushing her teeth.
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 client with alopecia should cover the head if the client will be exposed to extremes of temperature.
True
An adult client who has been diagnosed with a rectal tumor is scheduled to begin treatment with cisplatin.The nurse has conducted client teaching about the possibility of nausea and vomiting. In order to reduce the client's risk of severe nausea, the nurse should:
administer a combination of antiemetics prior to the administration of the drug.
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:
drink a lot of water.
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
What health education topic should the community health nurse emphasize when planning care for a client who will be prescribed an oral chemotherapy drug for the next several months while recovering at home?
techniques for safely handling the drug
A female client 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 client's drug regimen and the client 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 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."
A client on the oncology unit has begun chemotherapy with a regimen that includes bendamustine. The client has begun to experience alopecia. The nurse should prioritize assessments related to what potential nursing diagnosis?
Disturbed body image
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
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.
The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?
allopurinol
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