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36 Cards in this Set
- Front
- Back
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What are common side effects of chemotherapy?
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• Anemia - low RBC, Hgb • Fatigue - anemia, poor eating • Infection - bone marrow supression; neutropenia • Sterility - egg & sperm death • Stomatitis - mouth inflammation from bacteria growth • Nephrotoxicity & Hepatoxicity - harsh drug effects • Constipation - pain meds • Nausea - medicine • Electrolyte issues - dehydration • Impaired skin integrity - not eating, poor nutrition, immobility • Bleeding, bruising - Thrombocytopenia • Cold body temp. - hair loss |
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Critical Thinking Question
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A 50 year old woman diagnosed with metastatic breast cancer is concerned about how much time she has left with her family. What is your best response?
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Anemia
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low hemoglobin
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Neutropenia
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Decreased WBC
Neutrophils make up 50-70% of WBC’s |
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Thrombocytopenia
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Low platelets
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Which common side effect from chemotherapy may become a serious problem in older adults and require the attention of health care professionals?
a. Nausea and vomiting b. Fatigue c. Alopecia |
a. Nausea and vomiting
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What important laboratory value must be checked the morning of a patient’s scheduled chemotherapy?
Hemoglobin Platelets RBC WBC |
WBC
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Chemotherapy affects normal cells and cancer cells. What are the most common cell types that are effected?
a. Intestinal b. Skin c. Lung d. Hair e. Brain |
a.b.d. - skin, GI cells, hair (the rapidly dividing cells)
additionally - mucous membranes, bone marrow production - RBCs, WBCs, Neutrophils, Platelets |
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What is the action of the antineoplastics?
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• They don't kill tumor cells directly;
1- slow it down for the immune system to take over 2- Paliative Care; isn't a cure but prolongs life quality. |
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Benign Neoplasm Characteristics
• Non-Cancerous |
- smooth
- encapsulated - stationary - non life-threatening; excessive growth in size could become an issue |
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Melignant Neoplasm Characteristics
• Cancerous |
- irregular shape
- invade local tissue - ulcerate through skin - "Metastasize" - move through body via. blood and lymph systems |
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Antineoplastic Antibiotics
• Doxorubicin |
- Cell Cycle Non Specific (CCNS)
- used for solid tumors - hematologic malignancies * problem is that they also attack human cells in addition to bacteria |
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Antimetabolites
• Methrotexate (bad cell killer) • Leucovorin (good cell protector) |
- (CCS) - Synthesis phase
- used for solid tumors - Methrotexate enters the cell and kills the cancer - Leucovorin - protects the healthy cells against the effects of Methrotexate |
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Mitotic Inhibitors
• Taxol |
- protects mytosis phase
- CCS - M Phase - uses ovarian cancer if its a CCS-M doesn't it stop the Mytosis phase ?????? |
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Cell Growth Cycle
G-0(resting), G-1 (gathering of components) S (synthesizing, DNA is doubled), G-2 (second gathering to prepare for cell division), Mytosis (division) |
Cell cycle-nonspecific (CCNS)
Cell cycle-specific (CCS) • only affect a cell in a specific part of the growth cycle |
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Why do we wait about 4 weeks between chemo treatments?
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(G-0) resting phase of cell cycle needs to come out (G-1) emerge
• Healthy cells need time to catch up after being killed off |
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Alkylating Drugs
• Cisplatin |
- Affect all phases (CCNS)
- For rapid growing cells |
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Anti-neoplastic Agents
1 - Alkylating 2 - Antibiotics 3- Antimetabolites 4- Mitotic Inhibitors |
1 - for fast cell growth (CCNS) 2 - tumors, hematologic cancer (CCNS) 3 - tumors (CCS) - Synthesis 4 - ovarian cancer (CCS) - Mytosis |
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Why do we give a resque drug (Leucovorin) with an Antimetabolite drug (Methotrexate)?
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Because the Leucovorin is needed to save the "good cells" from the effects of Methotrexate is killing the cancer
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What are Primary and Secondary cancers?
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a person is diagnosed with breast cancer that spreads to the brain. The breast cancer is the Primary and the brain cancer is Secondary
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What are hematopoieitic growth factors?
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-stimulate red & white blood cell production & maturation
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-Filigastrim (neupogen) & sargramostim (leukine
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are used to enhance the WBC
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-Pegfiligastrim (Neulasta)
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for pt. w/ decreased WBC
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-Epotein alfa recombinant (procrit) or Epogen
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administered to maintain or increase the pt.’s RBC level
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What are a few nursing diagnoses for patients on antineoplastics?
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-Body image disturbance r/t loss of hair
-potention for infection r/t neutropenia -Altered nutrition- less than body requirement r/t loss of appetite; sores in oral cavity -risk for impaired skin integrity r/t lesions in oral mucosa |
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What are nursing implications for patients on antineoplastics?
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-antiemetics routinely (not PRN)
-food to preference & pleasing -frequent oral care -avoid spicy foods -wigs -heat is lost through head Sperm and egg harvesting -frequent rest periods -Spread activities throughout the day |
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Platelet Counts
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normal adult- 150,000-400,000
risk - 40,000 severe risk - 20,000 |
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Nursing Implications with Thrombocytopenia
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Bleeding Risks:
- straight raisors, soft toothbrush, IV sites - question orders for IM injections, catheters, supositories |
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Nursing Implications with Cancer Patient
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"Reverse Isolation" - to protect them from us- seperate wings
- strict aseptic techniques - monitor for infections - monitor for & protect against bleeding |
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Hepototoxicity
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labs - Alt, Ast, Alk phos
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Nephrotoxicity
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Labs - creatinin, BUN
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Hemoglobin Levels
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12,000-14,000
Hgb- male 13.5-18/ female 12-15 |
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Why do we check Neutrophil Counts?
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If numbers are too low, the patient might not be able to go through another treatment of chemo.
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Why are Antineoplastics often given in combinations?
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To affect cells in different growth cycles
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What should nurses know about handling antineoplastic drugs?
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- Always wear gloves
- Toxic through skin - Pregnant healthcare workers shouldn't handle |
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What to know about antineoplastic drugs and IV use?
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High vesicant drug, can cause necrosis of skin
- Extravasation - drug leaks into the surrounding area of the IV |
