Med-Surg Ch. 22
What physical symptom is a nurse caring for a patient with: neutropenia most alert for and reports immediately?
Any temperature elevation
Which instructions should the nurse provide to a patient to protect the skin during radiation therapy? Select all that apply.
"Wear soft clothing over the skin at the radiation site. 'Only go outdoors in the early morning or evening. Wash the irradiated area gently with either soap and water or water only.
Which statement made by a patient allows the nurse to recognize whether the patient receiving brachytherapy for ovarian cancer understands the treatment plan?
'I will have a radioactive device in my body for a short time.
The health care provider is reviewing treatment options with a young woman diagnosed with breast cancer and her family. Which statement by the family indicates a need for better coping skills regarding the patient's treatment?
'My grandmother died of cancer when I was a child. I do not want to watch that again or have my children go through that.'
The health care provider is reviewing treatment options with a young woman diagnosed with breast cancer and her family. Which statement by the family indicates a need for a better coping skills regarding the patient's treatment?
'My grandmother died of cancer when I was child. I do not want to watch that again or have my children go through that.'
A newly graduated RN has just finished a 6-week orientation to the oncology unit. Which patient is most appropriate to assign to the new graduate?
A 45-year-old with pancytopenia who will require IV administration of erythropoietin
The nurse teaches a patient that intraperitoneal chemotherapy will be delivered to which part of the body?
Abdominal cavity
Which term describes the administration of chemotherapy along with surgery or radiation?
Adjuvant therapy
Which chemotherapy agent inhibits cell division in cancer cells by cross-linking their deoxyribonucleic acid (DNA) and preventing the synthesis of DNA and ribonucleic acid (RNA)?
Alkylating agents
The nurse is caring for a patient who is receiving rituximab for treatment of lymphoma. During the infusion, it is essential for the nurse to observe for which side effect?
Allergy
A patient who is undergoing chemotherapy for breast cancer reports problems with concentration and memory. Which nursing intervention is indicated at this time?
Allow the client an opportunity to express her feelings.
A patient who is undergoing chemotherapy for breast cancer Which reports problems with concentration and memory. nursing intervention is indicated at this time?
Allow the patient an opportunity to express her feelings.
Which chemotherapy drug is an alkylating agent?
Altretamine
A patient with small cell lung cancer is administered cisplatin as a short-term infusion in normal saline. Which cytoprotectant is given prior to cisplatin to decrease kidney damage?
Amifostine
What are the common side effects of chemotherapy on the bone marrow? Select all that apply.
Anemia Neutropenia Thrombocytopenia
Mercaptopurine is an oral chemotherapeutic agent used in acute lymphocytic leukemia. Which drug category does it belong to?
Antimetabolite
A female patient who is about to undergo chemotherapy is distressed about the possibility of losing her hair. What is the priority nursing action in this situation?
Ask the patient how she feels about her hair in relationship to body image.
The nurse has received in report that a client receiving chemotherapy has severe neutropenia. Which interventions does the nurse plan to implement? (Select all that apply.)
Assess for fever. Administer pegfilgrastim Do not permit fresh flowers or plants in the room. Teach the client to omit raw fruits and vegetables from the diet.
Which nursing interventions help prevent extravasation in a patient who is receiving combined chemotherapy? Select all that apply.
Assessing the site of drug administration for pain, infection, or tissue loss Closely monitoring the intravenous site before, during, and after administration of vesicants
What are some of the precautions to be taken in providing nursing care to patients with sealed radioactive implants? Select all that apply.
Assign the patient to a private room with a private bath. Wear a lead apron during care, keeping the apron between the nurse and the patient.
Which safety principles are correct about radiation therapy for patients with cancer? Select all that apply.
Brachytherapy is the placement of a radioactive source within the body, so all body excreta are radioactive during this time. Unsealed isotopes are radioactive, so they should remain in sealed containers at all times, even during planned treatment. Although stereotactic body radiotherapy uses arradiation source outside the body, the patient's excreta are radioactive. Patients receiving 'high dose rate implants can go home during the several days of their therapy.
When caring for the patient receiving cancer chemotherapy, which signs or symptoms related to thrombocytopenia should the nurse report to the health care provider? Select all that apply.
Bruises Petechiae Epistaxis
Which method of radiation treatment delivery uses radioactive isotopes either in solid form or within body fluids?
Brachytherapy
What are key points for the nurse to include in patient education about skin care during radiation therapy? Select all that apply.
Clean skin cautiously to avoid removing ink or dye markings. Avoid exposure of the irradiated skin areas to heat or sun. Protect the irradiated area with soft, nonconstrictive clothing.
Which finding alarms the nurse when caring for a patient receiving chemotherapy who has a platelet count of 17,000/mm^3?
Change in mental status
Which instruction is most appropriate for the nurse to convey to the patient with chemotherapy-induced neuropathy?
Consume a diet high in fiber.
When caring for the patient with chemotherapy-induced mucositis, which intervention will be most helpful?
Providing oral care with a disposable mouth swab.
A patient is being treated with chemotherapy for breast cancer. Which prescribed drug does the nurse administer to the patient to prevent severe anemia caused by the chemotherapy?
Darbepoetin alfa
A patient who has just completed combination chemotherapy and radiation therapy states, 'I will be so glad to get back to normal.' Which radiation therapy-related information is important for the nurse to reinforce? Select all that apply.
Skin in the radiation path remains more sensitive to sunburn, so avoid direct skin exposure for 1 year after therapy. Fatigue may last for months after therapy ends, so continue to utilize energy conservation measures and exercise regularly.
A patient has been diagnosed with cancer. Which primary factors determine which type of cancer treatment that patient may receive? Select all that apply.
Specific type of cancer Evidence of cancer spread Patient's general hea;th
The nurse is caring for a patient with mucositis. Which self- management instruction is beneficial for this patient? Select all that apply.
Examine the mouth every four hours. Use a soft-bristled brush or sponge to brush the teeth and tongue.
Which side effect is commonly found in women who are taking androgen for the hormonal manipulation of cancer?
Facial and chest hair
Which potential side effects does the nurse include in the teaching plan for a patient undergoing radiation therapy for laryngeal cancer? Select all that apply.
Fatigue Change in taste Changes in skin of the neck Difficulty swallowing
Which energy type is commonly used for radiation therapy?
Gamma rays
The oncology nurse is caring for a group of patients receiving chemotherapy. The patient with which sign/symptom is displaying bone marrow suppression?
Hemoglobin of 7.4 and hematocrit of 21.8
What risk is associated with a low leukocyte count following chemotherapy?
Infection
When caring for a patient receiving chemotherapy, the nurse plans care during the nadir of bone marrow activity to prevent which complication?
Infection
Which route of administration is preferable for chemotherapy treatment of ovarian cancer?
Intraperitoneal
What roles does pharmacogenomics play in cancer treatment? Select all that apply.
It allows a more individualized approach to chemotherapy. It can determine the sensitivity to various therapeutic agents. It can assist with side effect management during therapy.
Which are potential problems for patients who are receiving hormonal therapy for cancer? Select all that apply.
Liver dysfunction Thromboembolism Acne
Which personal protective equipment (PPE) are necessary when preparing, giving, or disposing of chemotherapy drugs? Select all that apply.
Mask Gown Gloves Eye shield
Which term describes the occurrence where bone marrow activity and white blood cell counts are at their lowest levels after chemotherapy?
Nadir
What is the most significant factor resulting from cancer treatment that places patients at increased risk for infection?
Neutropenia
What are some of the serious hematopoietic side effects of aggressive chemotherapeutic agents? Select all that apply.
Neutropenia Thrombocytopenia
What immediate action should the nurse take if extravasation occurs during vesicant chemotherapy administration?
OWithdraw the vesicant infusion
Which medication does the nurse plan to administer to a patient before chemotherapy to decrease the incidence of nausea and vomiting?
Ondansetron
Which statement correctly describes oral chemotherapy agents as compared to traditional intravenous agents?
Oral chemotherapy drugs are just as toxic as traditional intravenous chemotherapy agents.
For individuals with cancer who are undergoing chemotherapy, bone marrow suppression places these individuals at risk for life- threatening infections. What is the most common cause of these infections?
Overgrowth of the patient's own normal flora
The RN working on an oncology unit has just received reports on these patients. Which patient should be assessed first?
Patient with chemotherapy-induced neutropenia who has just been admitted with an elevated temperature
Which law or practice guideline did the Occupational Safety and Health Administration (OSHA) and the Oncology Nursing Society (ONS) establish?
Personal protective equipment (PPE) should be used when handling chemotherapy drugs.
Which patient problem does the nurse set as the priority for the patient experiencing chemotherapy-induced peripheral neuropathy?
Potential for injury related to sensory and motor deficits
Which type of surgery is performed to remove tissues that are at risk of becoming cancerous?
Prophylactic
Colonoscopy results indicate that a patient has polyps in the colon region. The primary health care provider (PHP) recommends: surgery to remove the polyps because of the patient's strong family history of cancer. The nurse recognizes that which type of surgery has been suggested?
Prophylactic surgery
For patients undergoing surgery for cancer treatment, what specific cancer-related needs are critical nursing priorities? Select all that apply.
Psychosocial support for the patient and family Achieving or maintaining maximum function
What does the nurse teach a cancer patient who is worried about scalp injury and body image changes? Select all that apply.
Purchase a wig before therapy begins. Avoid direct,sunlight on the scalp by wearing a hat or other head covering.
Which therapy given to a patient with cancer may alter taste and cause fatigue?
Radiation therapy
Breast reconstruction after a mastectomy is an example of which surgery type?
Reconstructive
An outpatient patient is receiving photodynamic therapy. Which environmental factor is a priority for the patient to adjust for protection?
Reducing all direct and indirect sources of light.
The effect of chemotherapy agents on normal cells in the body leads to side effects related to which elements? Select all that apply.
Skin Hair Intestinal tissue Spermatocytes Blood-forming cells
Which principles guide the nurse in planning care for a patient receiving radiation therapy? Select all that apply.
The inflammatory response to radiation can lead to internal tissue fibrosis and scarring that may cause changes years later. Although the mechanism is not well understood, patients receiving radiation therapy even when focused to a specific field may experience significant fatigue.
Which statement listed by a nursing student regarding radiation- induced fatigue indicates a need for further learning?
The intensity of fatigue depends upon the radiation site.
Which statement best describes the mechanism by which chemotherapy can cure and increase survival time in individuals with cancer?
The killing effect on cancer cells is related to the ability to damage DNA and interfere with cell division.
The nurse corrects the nursing student when caring for a patient with neutropenia secondary to chemotherapy in which circumstance?
The student teaches the client that symptoms of neutropenia include fatigue and weakness.
What precautions should be included in home care teaching for patients with cancer-related thrombocytopenia? Select all that apply.
Use an electric shaver and soft toothbrush. Apply ice to any injury sites for an hour. Do not use enemas or rectal suppositories or engage in anal intercourse. Notify the health care provider immediately if persistent bleeding occurs.
Which statements about intravenous (IV) administration of chemotherapy are correct? Select all that apply.
Vesicant agents are very caustic to tissue if infiltration occurs. IV chemotherapy is the preferred route of chemotherapy in the treatment of cancer.
Which skin care precaution will the nurse teach the patient who is undergoing radiation therapy?
Wear soft clothing over the radiation site
