prep u antineoplastic drugs and targeted therapies

The nurse should exercise caution when administering antimetabolites to a client with:

bone marrow suppression.

Which is an example of an antineoplastic drug that interferes with amino acid production in the S phase and the formation of microtubules in the M phase?

vinblastine

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 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."

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

An oncology nurse is reviewing the pathophysiology of cancer and is discussing with a colleague the factors that contribute to the success or failure of a patient's chemotherapy. Which cancerous cell is most susceptible to the effects of chemotherapeutic drugs?

Cells that have a rapid mitotic rate

During ongoing assessment of a patient receiving 5-FU therapy, the nurse finds the patient's platelet count to be 92,000 cells/mm3. The nurse should do which of the following?

Consult the prescriber for discontinuation of the drug

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

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

The nurse is providing care for an older adult client who has stomatitis secondary to the administration of methotrexate. The nurse should assess for indications of what nursing diagnoses? Select all that apply.

Impaired skin integrity Risk for infection Imbalanced nutrition Risk for bleeding

During which phase of the cell cycle would a nurse expect a mitotic inhibitor to act?

M

A nurse is caring for a client who is undergoing chemotherapy. The client has experienced several episodes of vomiting. Which would be most appropriate for the nurse to do for this client as part of the ongoing assessment?

Measure all fluid intake and output

The nurse is caring for a patient who has just been diagnosed with adenocarcinoma of the pancreas. What antineoplastic does the nurse suspect the patient will receive?

Mitomycin

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 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 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 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 patient's current course of cancer treatment involves the administration of a conjugated monoclonal antibody. What characteristic of the drug is specified by the fact that it is classified as a conjugated drug?

The targeted therapy is combined with another substance that causes cell death.

What potential benefit is unique to biologic agent therapies?

They may affect cancer cells while leaving normal body cells unaffected.

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

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

A client has just been diagnosed with liver cancer, and the care team is finalizing the extensive chemotherapy regimen that will begin imminently. Administration of chemotherapeutic drugs is best achieved through which route?

a central venous catheter (CVC)

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 nurse is preparing an antineoplastic agent for a 9-year-old cancer patient. Before administering an antineoplastic agent, the nurse's most important action should be to:

check indexes of bone marrow functioning.

Many times a combination of antineoplastic medications are used to:

decrease the development of cell resistance.

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

A client is being treated on the oncology unit and has developed worsening adverse effects over the past several days of chemotherapy. Administration of filgrastim may aid in achieving what desired outcome?

increased leukocytes

A nurse is assessing a client who has chronic lymphoblastic myelogenous leukemia. The treatment plan includes hydroxyurea (Hydrea). The nurse will assess the client for:

leukopenia.

What is the defining characteristic of a sarcoma?

originates from connective tissue

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 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

A nurse has been assigned to a 55-year-old woman who has a malignant brain tumor. The client is receiving her first dose of carmustine. It will be critical for the nurse to observe for:

respiratory difficulty.

A nurse is caring for a client who is to undergo chemotherapy for leukemia. Which should be part of the initial assessment performed by the nurse? Select all that apply.

type and location of the neoplastic lesion previous or concurrent treatments presence of nonmalignant disease

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 client is prescribed cyclophosphamide as part of her treatment for non-Hodgkin's lymphoma. Which symptoms should the client be instructed to report to her health care provider immediately?

Pain and burning with urination

The dosages of the chemotherapy agents that will be administered are based primarily on what client variable?

weight

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.

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

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 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.

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

proliferation

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.