Pharm: Treatment of Cancer PrepU

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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 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."

The nurse is caring for a client newly diagnosed with a primary brain tumor. The client asks the nurse where the tumor came from. What would be the nurse's best response?

"Your tumor originated from a single cell that is genetically different from other cells in the surrounding tissue."

A client is experiencing intense nausea while being treated with chemotherapeutics. What actions should the nurse perform? Select all that apply.

> Ensure that the client has had a dietician consult > Administer antiemetics as prescribed > Provide the client with small, frequent meals

Cytotoxic antineoplastic medications can produce several adverse effects that can affect the treatment used. In caring for patients undergoing chemotherapy, for which of the following should monitoring occur? (Select all that apply.)

> Mucositis > Tetany

The nurse may be asked to administer which medication to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis?

Allopurinol (Zyloprim)

A nurse is caring for a patient being treated with antineoplastic drugs. The patient is at risk for thrombocytopenia due to bone marrow suppression. What should the nurse monitor for in this patient?

Bloody urine

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 patient undergoing antineoplastic drug therapy is administered an alkylating drug. The patient is also administered an aminoglycoside as an anti-infective agent. Which of the following interactions of the alkylating drug with the aminoglycoside should the nurse assess the patient for?

Increased risk of nephrotoxicity

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 undergoing chemotherapy. The client has experienced several episodes of vomiting. Which activity should the nurse perform as part of ongoing assessment for signs of dehydration and electrolyte imbalances?

Measure all fluid intake and output

Which agent would the nurse expect to be administered orally?

Methotrexate

A nurse has completed a medication reconciliation of a patient who has been admitted following a motor vehicle accident. Among the many drugs that the patient has received in the previous year is rituximab. The nurse would be justified in suspecting the patient may have received treatment for which of the following diseases?

Non-Hodgkin's lymphoma

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 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

The client receiving a first infusion of paclitaxel reports chills and dyspnea. The oncology nurse assesses the client and observes facial flushing, wheezing, and extreme anxiety. What is the priority intervention by the nurse?

Stop the infusion.

A patient is to start with chemotherapy. The patient is worried about going bald in the course of the treatment. How can the nurse assist the patient in being comfortable with his or her body image?

Suggest the use of a wig or cap.

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 postmenopausal woman with breast cancer will most likely be treated with which anti-estrogen drug?

Tamoxifen

An older adult woman has been diagnosed with acute lymphoblastic leukemia (ALL) and her care team has identified potential benefits of imatinib. Which characteristic of this patient's current health status may preclude the use of imatinib?

The patient has chronic heart failure resulting in significant peripheral edema.

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 patient with a recent diagnosis of chronic myelogenous leukemia (CML) is discussing treatment options with his care team. What aspect of the patient's condition would contraindicate the use of cyclophosphamide for the treatment of leukemia?

The patient's bone marrow function is significantly depressed.

An adverse effect of tamoxifen therapy involves menopausal symptoms.

True

Anemia from chemotherapy treatment is the result of bone marrow suppression.

True

A nurse is caring for a patient who is at risk for erythema during antineoplastic drug therapy. What should the nurse suggest to this patient?

Wear loose protective clothing.

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 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

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

proliferation

Intravenous carmustine has been prescribed for a patient with cancer. The nurse should help relieve the discomfort of pain and burning during the infusion by

slowing the infusion.


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