antineoplastic drugs and targeted therapies
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 49-year-old client is diagnosed with ovarian cancer. What is a characteristic of malignant cells that differentiates them from normal body cells?
Cancerous cells grow in an uncontrollable fashion
A client with leukemia is being treated with a combination of antineoplastics, including methotrexate. The client's most recent laboratory results indicate the client is experiencing bone marrow suppression. What is the nurse's priority action?
Ensure that all staff and visitors adhere to infection control precautions.
During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act?
M
A recent nursing graduate is receiving special training to become certified in handling and administering chemotherapy drugs. This special training is necessary because of what nursing diagnosis among clients receiving chemotherapy?
risk for injury related to chemotherapy
a client who is being treated with an antineoplastic medication for cancer is prescribed Kepivance. The client is refusing this medication, stating that "all these drugs are making everything worse," including the inside of her mouth. What would be an appropriate response from the nurse?
"Kepivance is used to protect the normal cells in your body from the chemotherapy."
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."
The client is taking ifosfamide as a component of cancer treatment and the client's oncologist has just added mesna to the client's medication regimen. How should the nurse best assess for the therapeutic effect of mesna?
Monitoring the client's urine output for signs of hematuria
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
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 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 client that it is a harmless and expected response to the drug.
What rationale should the nurse provide to the client when describing the necessity of recovery periods between treatment cycles of chemotherapy?
Time is needed to replace many of the healthy body cells killed by chemotherapy.
The mitotic inhibitors interfere with the ability of a cell to divide, and they block or alter DNA synthesis, thus causing cell death. For clients taking these drugs, the nurse should:
avoid any skin, eye, or mucous membrane contact with the drug.
A male client on 5-FU calls the clinic and reports that he has between five and seven loose bowel movements daily. The nurse will instruct the client to:
notify the clinic if the stools are black or if there is evidence of blood.
A female client prescribed methotrexate for meningeal leukemia is asking the nurse about adverse effects of the drug. What would the nurse tell this client should be avoided while taking methotrexate?
pregnancy
The nurse should encourage the client to implement which intervention in order to minimize the risk of developing chemotherapy-triggered mucositis?
thoroughly rinse the mouth often, especially before and after meals
The dosages of the chemotherapy agents that will be administered are based primarily on what client variable?
weight
The nurse should exercise caution when administering antimetabolites to a client with:
bone marrow suppression.
A 79-year-old woman has recently moved to a long-term care facility, and the nurse at the facility is conducting a medication reconciliation. The nurse notes that the woman has recently been taking tamoxifen. The nurse is justified in concluding that the woman has a history of what malignancy?
breast cancer
A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis?
Hodgkin lymphoma
A client's chemotherapy regimen has been deemed successful, but the client is experiencing debilitating nausea and vomiting. These adverse effects should signal the nurse to the possibility of what nursing diagnosis?
Imbalanced nutrition: less than body requirements
A client with breast cancer being treated with tamoxifin is also taking the oral anticoagulant coumadin for chronic atrial fibrillation. What is important to monitor in this client?
Prothrombin time
What can the oncology nurse do to minimize the exposure risk to chemotherapeutic agents?
Review institutional policies and procedures related to chemotherapy
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.
A client has been diagnosed with a brain tumor and is dealing with this diagnosis by seeking detailed information about cancer. The nurse would explain to the client that cancer is essentially a result of the disruption of the:
cell cycle.
A 39-year-old woman is receiving doxorubicin for the treatment of cancer. After each treatment, the client has acute nausea and vomiting accompanied by a slightly increased heart rate. The nurse will advise her to:
perform relaxation techniques after the treatments.
A client asks the nurse what cancer cell growth is called. What would the nurse tell the client?
proliferation
A pediatric patient with leukemia is being followed by a nurse. Prior to the administration of chemotherapy, the patient receives rasburicase. The nurse's follow-up care after administration of the drug will involve monitoring what?
uric acid levels
A 25-year-old female client is prescribed methotrexate to treat rheumatoid arthritis (RA). The nurse should teach the client to:
use an effective contraceptive.
A patient who will begin chemotherapy voices concern to the nurse about the accompanying nausea and vomitting. What is the best response by the nurse?
"We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them."
A client being treated with an antineoplastic medication is being discharged from the hospital. Which of the following teaching instructions is appropriate for this client?
"You will be excreting the antineoplastic medications in your stool and urine. As a precaution, double-flush the toilet with the lid closed so the chances of contact with the drug will be lessened."
An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing this client's laboratory work, the nurse should consequently prioritize assessment of which of the following?
BUN and creatinine
A client is undergoing treatment with chemotherapy. He calls the nurse and states that his mouth hurts and there are white patches on his tongue. The nurse suspects the white patches are a symptom of what?
Candidiasis
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 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
After teaching a group of students about antineoplastic antibiotics, the instructor determines that the teaching was successful when the students identify which drug as an example?
Doxorubicin
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 is caring for a client who is being treated with temozolomide in conjunction with radiation to the brain. The client has also started prophylactic therapy to prevent Pneumocystis pneumonia (PCP). Which instructions should the nurse convey to this client?
Stay away from crowds and ill individuals.
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 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 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 describes the process of giving multiple doses of chemotherapy with each dose, killing approximately 90% of the cancer cells. The body's own immune system will kill the few cancer cells that are left.
A client is undergoing a cytotoxic chemotherapy regimen for the treatment of stage III lung cancer. What effect will this regimen likely have on the client's hemostatic function?
The client's platelet count will decline.
A 54-year-old received a diagnosis of breast cancer several weeks ago and her current treatment regimen includes tamoxifen, a cell cycle-nonspecific antineoplastic drug. What is a characteristic of a cell cycle-nonspecific drug?
The drug is effective regardless of whether a cancerous cell is proliferating.
What potential benefit is unique to biologic agent therapies?
They may affect cancer cells while leaving normal body cells unaffected.
The nurse is preparing to administer doxorubicin for a client who has a diagnosis of neuroblastoma. What action should the nurse perform?
Wear personal protective equipment
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.
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
Which herbal product has the benefits of overall well-being, cancer prevention, dental health, and maintenance of heart and liver health as a result of being loaded with antioxidants?
green tea
Fewer adverse effects are associated with monoclonal antibody therapy than those of cytotoxic drugs. However, some of the potential adverse effects of monoclonal antibodies can be life threatening, including which effect?
heart failure and bleeding problems
