Karch's PrepU (Pharm) Ch. 14: Antineoplastic Agents
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? "Chemotherapy causes a lot of unpleasant side effects, and the advantage of targeted therapies is that these are all avoided." "Targeted therapies are often more effective than traditional chemotherapy, but the downside of this effectiveness is that adverse effects are more common and severe." "The adverse effects to targeted therapies are most often a result of the client's cancer, not the drugs themselves." "Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells."
"Both classes of drugs have adverse effects, but targeted therapies tend to have less of an effect on healthy body cells." Explanation: Targeted therapies are generally considered to be less toxic than traditional chemotherapy drugs. However, adverse reactions to targeted therapies can occur such as severe skin reactions, GI toxicities, skin reactions, and thrombosis.
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? "You may have hemorrhagic cystitis." "We need to notify the health care provider because this is a complication of the medication." "Let's get a urinalysis to confirm a urinary tract infection." "The reddish urine is an expected response to the drug."
"The reddish urine is an expected response to the drug." Explanation: Reassure clients that reddish urine after doxorubicin injection is a harmless and expected response to the drug. This reaction may happen within 1 to 2 days postinfusion.
A patient who will begin chemotherapy voices concern to the nurse about the accompanying nausea and vomiting. 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." "We can relieve your nausea and vomiting with drugs but you can have them only before and after the chemotherapy." "Nausea and vomiting are an unfortunate side effect of the chemotherapy. We will do what we can but you may have it anyway." "Not everyone has nausea and vomiting. Just wait to see how you will react to the chemotherapy."
"We can relieve your nausea and vomiting with antiemetic drug therapy. You should ask for these medications whenever you need them." Explanation: Reassure patients that nausea and vomiting can be relieved with antiemetic drug therapy and emphasize that they should request these agents when needed.
What information should the nurse share with a client prescribed an antineoplastic drug regarding the management of symptoms triggered by its affect on the chemoreceptor trigger zone (CTZ)? A combination of drugs may be prescribed to manage nausea and vomiting. Sufficient hydration will minimize the risk of dizziness. An antihistamine will be prescribed to manage excess secretions. A corticosteroid will be needed to manage related inflammation.
A combination of drugs may be prescribed to manage nausea and vomiting. Explanation: Antineoplastic drugs can directly stimulate the chemoreceptor trigger zone (CTZ) in the medulla to induce nausea and vomiting. A variety of antiemetic agents have been used in the course of antineoplastic therapy. Sometimes a combination of drugs is most helpful. It should also be knowledge that an accepting environment, plenty of comfort measures (e.g., environmental control, mouth care, ice chips), and support for the client can help to decrease the discomfort associated with the emetic effects of these drugs. The CTZ is not related to dehydration, secretion production, or inflammation.
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 what? Sodium and potassium BUN and creatinine Calcium and magnesium Arterial blood gases
BUN and creatinine Explanation: The antimetabolites may also be nephrotoxic. MTX use in clients with impaired renal function may lead to accumulation of toxic amounts or additional renal damage. Evaluation of the client's renal status should take place before and during MTX therapy. This adverse effect of MTX treatment supersedes the importance of electrolytes and ABGs, though these would also be considered.
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 do not require an energy source in order to proliferate. Cancerous cells grow in an uncontrollable fashion. Cancerous cells have a theoretically infinite life span. Cancerous cells are not responsive to the presence of drugs.
Cancerous cells grow in an uncontrollable fashion. Explanation: Malignant cells have lost the normal genetic regulation that controls cell growth, invading normal tissues and taking blood and nutrients away from these tissues. They grow in an uncontrolled fashion without regard to growth regulation signals (e.g., contact with other cells) that stop the growth of normal cells. Cancerous cells, like all cells, have a finite life span and need energy. Cancerous cells are responsive to drugs; this is the rationale for treatment with antineoplastics.
A child is prescribed an anthracycline drug. The nurse would teach the parents to observe for signs and symptoms of what adverse effect? Cardiotoxicity Dehydration Gallbladder disease Esophageal varices
Cardiotoxicity Explanation: Children who receive an anthracycline drug (e.g., doxorubicin) are at increased risk of developing cardiotoxic effects (e.g., heart failure) during treatment or after receiving the drug. Efforts to reduce cardiotoxicity include using alternative drugs when effective, giving smaller cumulative doses of anthracycline drug, and observing clients closely so that early manifestations can be recognized and treated before heart failure occurs.
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 what? Cell cycle Cell wall Lymphatic system Immune system
Cell cycle Explanation: Malignant cells have lost the normal genetic regulation that controls cell growth, invading normal tissues and taking blood and nutrients away from these tissues. In essence, the cell cycle has been pathologically disrupted. None of the other options accurately describe the disruption.
A client with colorectal cancer is being treated with oxaliplatin. Which potential adverse effect should the nurse explain to the client? Dysuria Kaposi's sarcoma Insomnia Cold-induced neurotoxicity
Cold-induced neurotoxicity Explanation: Cold-induced neurotoxicity is an adverse effect of oxaliplatin resulting from an effect on peripheral nerves, especially in the hands and feet. Dysuria, diarrhea, and insomnia are not closely associated with oxaliplatin as a result of its pharmacologic actions.
A nurse is preparing to administer etoposide to a client. Which assessment finding that could influence dosing should the nurse prioritize in the preadministration assessment? The emotional response Complete blood count Fluid intake and output Understanding of therapy
Complete blood count Explanation: The nurse should perform a complete blood count to provide baseline data for future reference due to the potential bone marrow suppression that can occur with etoposide. Emotional response to the disease, client understanding of therapy, and fluid intake and output are preadministration assessments not pertaining to the depressing effect of the bone marrow.
A client's chemotherapeutic regimen includes procarbazine. What is the client's most likely diagnosis? Hodgkin lymphoma Neuroblastoma Astrocytoma Pancreatic cancer
Hodgkin lymphoma Explanation: Procarbazine (Matulane) is used in combination therapy for treatment of stages III and IV of Hodgkin disease.
Which would the nurse expect to administer to counteract the effects of methotrexate? Alprazolam Leucovorin Metoclopramide Aprepitant
Leucovorin Explanation: Leucovorin is administered to counteract the effects of treatment with methotrexate. Alprazolam, metoclopramide, and aprepitant are used to help alleviate the nausea and vomiting associated with chemotherapy.
During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act? M G0 G1 S
M Explanation: Mitotic inhibitors act during the M phase of the cell cycle.
Which agent would the nurse expect to be administered orally? Cytarabine Fluorouracil Gemcitabine Methotrexate
Methotrexate Explanation: 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 male client is informed that the latest tests indicate that his cancer has spread to his liver. The client receives capecitabine as part of his treatment regimen. What would the nurse expect the health care provider to do? Increase the dose of capecitabine. Discontinue the capecitabine. Add routine blood transfusions to the client's treatment regimen. Monitor the client closely and repeat LFTs routinely.
Monitor the client closely and repeat LFTs routinely. Explanation: Capecitabine blood levels are significantly increased with hepatic impairment, and clients with liver metastases should be monitored closely.
A patient with a diagnosis of chronic myeloid leukemia has met with the oncologist, who has recommended treatment with the kinase inhibitor imatinib. What route of administration will the client receive? Daily intramuscular injections throughout the course of treatment Peripheral IV administration three times a day for 7 to 10 days Weekly IV infusions over 6 to 8 hours through a central line Oral administration of imatinib in a home setting
Oral administration of imatinib in a home setting Explanation: Imatinib is administered orally. Consequently, it can be administered in an outpatient environment. IV or IM administration is not performed.
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? Lymphoma Lung cancer Skin cancer Prostate cancer
Prostate cancer Explanation: In male patients, antiandrogens are used to treat prostate cancer. They are not included in treatment of lymphomas, skin cancer, or lung cancer.
A patient has just received the first dose of imatinib and the nurse on the oncology unit is amending the patient's care plan accordingly. What nursing diagnosis is most appropriate in light of this addition to the patient's drug regimen? Risk for Infection related to bone marrow suppression Risk for Acute Confusion related to adverse neurological effects of imatinib Risk for Impaired Skin Integrity related to exaggerated inflammatory response Risk for Deficient Fluid Volume related to changes in osmotic pressure
Risk for Infection related to bone marrow suppression Explanation: Like many cancer treatments, imatinib causes bone marrow suppression that creates a consequent risk of infection. The drug does not typically result in cognitive changes, fluid overload, or skin breakdown.
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 Explanation: 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.
The nurse is administering a client's chemotherapeutic drug through a peripheral IV site, and the nurse observes that extravasation has occurred. What is the nurse's best action? Administer a bolus of 0.9% NaCl or 0.45% NaCl to dilute the drug. Stop the infusion and inform the health care provider immediately. Stop the infusion, document the event, and monitor the IV site closely. Establish another IV site so that the antidote can be administered.
Stop the infusion and inform the health care provider immediately . Explanation: Extravasation should prompt the nurse to stop the infusion and collaborate promptly with the care provider. A bolus would cause more harm than benefit by distributing the drug in compromised tissue. Monitoring is not a sufficient response, and another IV site may or may not be needed.
The client has just been started on an alkylating agent to treat testicular cancer. What assessment finding would suggest that the client is experiencing a common adverse effect of this medication? The client's most recent laboratory results indicate pancytopenia. The client describes "bone pain" in the lumbar and thoracic spine. The client is oriented to person but not to place and time. The client describes the mood as "bleak" and "dark."
The client's most recent laboratory results indicate pancytopenia. Explanation: Hematological effects include bone marrow suppression, with leukopenia, thrombocytopenia, anemia, and pancytopenia, secondary to the effects of the drugs on the rapidly multiplying cells of the bone marrow. Bone pain, depression, and disorientation are not common adverse effects of alkylating agents.
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. The client will be at increased risk of deep vein thrombosis (DVT). The client will require prophylactic heparin. The client will likely experience thrombocytosis.
The client's platelet count will decline. Explanation: Thrombocytopenia, not thrombocytosis, is a common adverse effect of cytotoxic chemotherapy. Heparin is consequently contraindicated, and DVT is not a priority risk.
A client with Hodgkin's disease has been prescribed vincristine. What nursing consideration should the nurse prioritize when administering this drug? The nurse should encourage the client to eat six small meals a day. The nurse should avoid any skin, eye, or mucous membrane contact with the drug. The nurse should avoid using a distal vein. The nurse should check for extravasation when the infusion is over.
The nurse should avoid any skin, eye, or mucous membrane contact with the drug. Explanation: Special care needs to be taken when administering mitotic inhibitors. The nurse should avoid any skin, eye, or mucous membrane contact with the drug. This type of contact can cause serious reactions and toxicity for the nurse. The nurse should check for extravasation frequently during the infusion and not wait until the infusion is completed. A distal vein should be use. Nausea and vomiting are commonly experienced adverse effects of these drugs. Small meals may help the client to maintain adequate nutrition, but this is not the important concern when administering the drug.
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.
The use of three agents decreases the development of cell resistance. Explanation: 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.
What potential benefit is unique to biologic agent therapies? They may affect cancer cells while leaving normal body cells unaffected. They may be administered long term without the need for regular blood work. Administered does not require a certified chemotherapeutic nurse. Cytotoxic adverse effects are rarely experienced.
They may affect cancer cells while leaving normal body cells unaffected. Explanation: Biologic agents target cellular differences between the malignant and normal cells. Consequently, they may kill cancer cells while leaving normal body cells unaffected. Like all drugs, they have adverse effects. They require exceedingly careful administration and necessitate close monitoring by specially trained staff.
A female client is prescribed methotrexate for meningeal leukemia. What health education should the nurse prioritize? Use reliable forms of barrier contraception. Discontinue oral contraceptives. Avoid grapefruit juice. Abstain from alcohol until 7 days after treatment.
Use reliable forms of barrier contraception. Explanation: Antimetabolites are contraindicated for use during pregnancy and lactation because of the potential for severe adverse effects on the fetus and neonate. There is no need to discontinue oral contraceptives, but barrier methods should also be used. There is no need to avoid grapefruit juice and prolonged abstinence from alcohol is not required.
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
With food and a large glass of water Explanation: Imatinib should be taken with food and a large glass of water.
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: place the client on a low-residue diet. encourage the client to request antiemetics if the nausea becomes unbearable. administer a combination of antiemetics prior to the administration of the drug. ensure that the client is NPO from midnight prior to receiving the drug.
administer a combination of antiemetics prior to the administration of the drug. Explanation: Antiemetics should be administered proactively rather than waiting until the client's nausea becomes unbearable. A combination approach is often effective. A low-residue diet is unnecessary, and withholding food does not necessarily reduce nausea.
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: place the client on a low-residue diet. ensure that the client is NPO from midnight prior to receiving the drug. administer a combination of antiemetics prior to the administration of the drug. encourage the client to request antiemetics if the nausea becomes unbearable.
administer a combination of antiemetics prior to the administration of the drug. Explanation: Antiemetics should be administered proactively rather than waiting until the client's nausea becomes unbearable. A combination approach is often effective. A low-residue diet is unnecessary, and withholding food does not necessarily reduce nausea.
Which agents would be considered cancer non-cell cycle specific agents? alkylating agents antimetabolites mitotic inhibitors protein tyrosine kinase inhibitors
alkylating agents Explanation: Alkylating agents affect cells in all phases of the cell cycle and are considered non-cell cycle specific. Antimetabolites are considered to be S phase specific agents. Mitotic inhibitors are cell cycle-specific agents working in the M phase of the cell cycle. Protein tyrosine kinase inhibitors target specific enzymes needed for protein building by specific tumor cells. They do not affect healthy human cells.
The nurse is assessing a client for adverse effects related to methotrexate therapy. What diagnostic finding should the nurse prioritize? serum osmolality creatinine clearance electrocardiogram (ECG) calcium and magnesium levels
creatinine clearance Explanation: Methotrexate is nephrotoxic. Consequently, the nurse must carefully follow indicators of the client's renal function. Electrolyte and water disturbances and cardiac conduction disorders are much less likely adverse effects.
A 54-year-old male patient with small-cell lung cancer is receiving etoposide. The nurse will carefully monitor for:
hypotension Explanation: The nurse should observe the client closely for hypotension and anaphylactic reactions. The drug should not cause hypertension, hypoglycemia, or tachycardia.
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
menopausal effects Explanation: 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 57-year-old male patient who has been prescribed doxorubicin for small-cell lung cancer is advised by the nurse to avoid taking aspirin or drugs that contain aspirin because it may: cause extravasation injury. promote bleeding. cause a radiation recall reaction. cause acute nausea and vomiting.
promote bleeding. Explanation: It is essential to caution the client against taking aspirin or drugs that contain aspirin while on doxorubicin drug therapy because aspirin may promote bleeding during periods of suppressed bone marrow function. Aspirin will not cause extravasation injury, radiation recall reaction, or acute nausea and vomiting; these are adverse effects of doxorubicin.
The nurse is caring for a client whose current antineoplastic regimen includes bicalutamide. The nurse should anticipate what additional aspect of this client's cancer treatment? thyroidectomy hemicolectomy total mastectomy prostatectomy
prostatectomy Explanation: Bicalutamide is administered in combination with a luteinizing hormone for the treatment of advanced prostate cancer. This medication would not be effective for treating bowel, thyroid or breast cancer because it is a hormone modulator and works only on androgen-receptor sites
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. drink milk with the medication. expect a mild rash and itching. take a pain reliever for sore throat.
use an effective contraceptive. Explanation: Women of childbearing age should use an effective contraceptive during therapy with methotrexate. When taking methotrexate, the client should be instructed to notify the primary health care provider immediately at first sign of a rash or sore throat. Drinking milk with the medication is not a specific teaching point for methotrexate use.
A patient who is receiving methotrexate is also receiving leucovorin. The nurse understands that this drug is being given for which reason? Counteract effects of methotrexate Synergistic effect on the cancer cells Relief of nausea and vomiting Reduction of renal toxicity risk
Counteract effects of methotrexate Explanation: Leucovorin is administered with methotrexate to counteract the effects of methotrexate treatment.
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. Space out the client's care to preserve energy and prevent fatigue. Encourage the client to limit physical activity in order to reduce the risk of bleeding. Provide small quantities of food several times per day, as tolerated.
Ensure that all staff and visitors adhere to infection control precautions. Explanation: The client's combination of cancer and bone marrow suppression creates an acute risk for infection. As a result, infection control is vital to maintaining the client's health and safety. Nutrition and energy conservation strategies are also important, but infection control is a safety priority. The client likely has a risk for bleeding, but the harm of activity limitation outweighs the benefits for most clients.
A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include? Hemoglobin replacement therapy Diuretics Hormonal therapies Antidiuretic hormone
Hormonal therapies Explanation: Hormonal therapies that block the effects of estrogen (in an estrogen-responsive tumor) and androgen (in an androgen-responsive tumor), respectively, are essential in the treatment of breast and prostate cancers.
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? Acute pain Adult failure to thrive Ineffective therapeutic regimen management Imbalanced nutrition: less than body requirements
Imbalanced nutrition: less than body requirements Explanation: Nausea and vomiting are major threats to the client's nutrition. Failure to thrive is typically a chronic, rather than acute, health problem. Pain does not necessarily accompany nausea, and there is no indication that this client is not maintaining the necessary regimen.
A 39-year-old client has begun taking tamoxifen to reduce the risk of contralateral breast cancer. The client is now reporting hot flashes and dysmenorrhea. What is the nurse's best action? Tell the client to stop taking the drug immediately and contact the prescriber. Encourage the client to ask their provider about the possible use of dexrazoxane to relieve these effects. Encourage the client to speak with their care provider about hormone therapy. Inform the client that these are likely adverse effects of drug therapy.
Inform the client that these are likely adverse effects of drug therapy. Explanation: Adverse effects of tamoxifen include hot flashes, rash, nausea, vomiting, vaginal bleeding, menstrual irregularities, edema, pain, cerebrovascular accident, and pulmonary emboli. These effects do not likely warrant discontinuing the drug. Hormone therapy would not be prescribed for the sole purpose of addressing these adverse effects. Dexrazoxane confers cardioprotective effects; it does not address adverse effects of tamoxifen therapy.
How can a nurse best prevent tissue damage caused by an antineoplastic 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
Inspect the site frequently for redness or swelling Explanation: 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.
Which would the nurse identify as an antineoplastic antibiotic? Mitomycin Teniposide Vinblastine Docetaxel
Mitomycin Explanation: Mitomycin is an example of an antineoplastic antibiotic. Teniposide, vinblastine, and docetaxel are examples of mitotic inhibitors.
When describing the process of cancer cell growth to a client, the nurse addresses angiogenesis. Which description would the nurse include? A process that involves the cells traveling to other areas of the body to develop new tumors The process of creating new blood vessels to supply oxygen and nutrients to the cells The process of growing without the usual homeostatic restrictions that regulate cells A process in which the cells lose their ability to differentiate and organize
The process of creating new blood vessels to supply oxygen and nutrients to the cells Explanation: Angiogenesis refers to the process in which abnormal cells release enzymes that generate blood vessels in the area to supply both oxygen and nutrients to the cells. Metastasis refers to process of traveling from the place of origin to develop new tumors in other areas of the body. Autonomy refers to the process of growing without the usual homeostatic restrictions that regulate cell growth and control. Anaplasia refers to the process in which the cells lose their ability to differentiate and organize, which leads to a loss in their ability to function normally.
The nurse is caring for a client who is receiving a combination of antimetabolite agents. The client has been told that alopecia is likely to occur, and the client is tearful and distraught about this. What is the nurse's best response? Reassure the client that other people who are treated with cancer also experience this. Encourage the client to view the hair loss as something that indicates cancer is being eradicated. Reassure the client that the hair loss will be temporary rather than permanent. Validate the client's sense of impending loss and offer guidance for getting a wig
Validate the client's sense of impending loss and offer guidance for getting a wig. Explanation: The nurse should empathically validate the client's sense of loss. Offering to assist with a practical solution is also useful. The facts that the hair loss is temporary and happens to other people are unlikely to provide any real consolation. Similarly, telling the client to see it as a positive is likely to be interpreted as simplistic.
The nurse is caring for a client who is receiving a combination of antimetabolite agents. The client has been told that alopecia is likely to occur, and the client is tearful and distraught about this. What is the nurse's best response? Reassure the client that other people who are treated with cancer also experience this. Encourage the client to view the hair loss as something that indicates cancer is being eradicated. Reassure the client that the hair loss will be temporary rather than permanent. Validate the client's sense of impending loss and offer guidance for getting a wig.
Validate the client's sense of impending loss and offer guidance for getting a wig. Explanation: The nurse should empathically validate the client's sense of loss. Offering to assist with a practical solution is also useful. The facts that the hair loss is temporary and happens to other people are unlikely to provide any real consolation. Similarly, telling the client to see it as a positive is likely to be interpreted as simplistic.
An oncology nurse is preparing to administer cytotoxic chemotherapy medications. Which measure best protects the nurse from harm related to the chemotherapy? Wear gloves when handling the client's soiled linens. Perform thorough hand hygiene using an alcohol handrub. Care for only one client receiving chemotherapy in any given shift. Administer medication intramuscularly whenever possible.
Wear gloves when handling the client's soiled linens. Explanation: Because of the drugs' toxicity, nurses who administer IV cytotoxic chemotherapy should be specially trained to administer the medications safely and use protective equipment when handling the medication or handling the client's soiled linens or excreta. Alcohol handrub will not negate the harmful effects of contacting a chemotherapeutic agent. The medication is not administered intramuscularly.
The nurse is providing medication education to a client with breast cancer who has been prescribed tamoxifen. How should the nurse explain the action of the drug? increases the viability of healthy cells that are adjacent to cancerous cells slows the growth of cancer cells induces apoptosis of cancer cells causes mutations of cancer cells
slows the growth of cancer cells Explanation: Antineoplastic hormone inhibitors slow the growth of cancer cells. They do not treat cancer by causing apoptosis (cell repair) or mutations. They do not influence healthy body cells in the area of the tumor.
