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40 Cards in this Set
- Front
- Back
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What is hydroxurea? |
Antineoplastic |
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How does hydroxurea work? |
Interferes with the synthesis of DNA, with no effect of RNA or protein. Increasing Hemoglobin F. |
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What is hydroxurea used to treat? |
Polycythemia Vera Sickle cell disease CML and other cancers |
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What labs do you want to check when on hydroxurea? |
Regular monitoring of CBC, BUN, Creatinine, uric acid, electrolytes, liver enzymes |
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Hydroxurea is contraindicated in? |
Contraindicated in severe anemia and neutropenia |
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What is Epogen/Procrit? |
It is a a biologic response modifier and stimulates erythropoiesis *Drug that changes your biologic response* |
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What is epogen/Procrit used for? |
Anemia due to chronic kidney disease Anemia due to treatment for cancer Anemia in critically ill patients |
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What do you want to monitor while giving Procit? |
Monitor their CBCs |
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What is Neupogen (filgrastim)? |
Biologic response modifier, hematopoietic stimulant that is produced through recombinant DNA. *Stimulates WBCs* |
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When do you want to give this medication to a cancer patient?
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After chemo, if you give before all the new WBCs will get destroyed |
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Neupogen is used for |
Leukemia and other cancers Chemotherapy related neutropenia AIDs related neutropenia Bone marrow and stem cell transplants |
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What do you want to monitor with Neupogen? |
Their CBC |
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For blood transfusions what do you want to do first? |
Verify blood product order Test donors/recipents blood for compatibility Compare patients blood band with blood bank tag. Compare blood band tag with blood product label Inspect blood for discoloration, gas bubbles, cloudiness. |
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When comparing the patients blood band with blood bank tag what are you checking? |
Correct pt name medical record number blood bank number for patient |
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When comparing the blood bank tag with blood product label what are you checking? |
Correct product RBC, platelets, etc unit number correct type expiration date |
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Why is it important that we educate the client about the blood transfusion. |
Because we are the one that needs to get consent. So we need to make sure the patient is fully aware of the risks and reasons to why we are doing it. |
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How soon after the transfusion do we do vital signs |
Assess vital signs before transfusion and 15 mins later and again once the treatment is finished. |
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At what speed do we want to administer the blood transfusion? |
Slowly! Check on patient frequently first 15-30 mins |
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What are unusual signs related to blood transfusion? |
Chills, SOB, hives, itching |
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When the patient is having unusual signs what should you do? |
Stop the blood immediately! Save tags, tubes and blood Call the dr! |
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How do we prepare the patient for a bone marrow aspiration biopsy? |
Talk to them, educate, tell them whats going on. |
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What nursing care is necessary during the bone marrow aspiration biopsy procedure? |
Anxiety med, pain med Also a sterile procedure no visitors in the room |
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How will the nurse care for the patient after bone marrow aspiration procedure? Including preparation for discharge? |
Hold pressure on spot, infection risk increases. We want to teach about infection and prevention. They can apply ice to decrease bleeding. |
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What follow up care is needed for bone marrow aspiration? |
None unless they have problems. The pain should go away 3-5 days |
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_____ ______ your own hematopoietic stem cells are removed before the high does chemotherapy or radiation is given and are then frozen for storage and later use. After your chemo or radiation is complete, the harvested cells are thawed and returned to you? |
Autologous transplant |
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_______ _______ the hematopoietic stem cells come from a donor, ideally a brother or sister with a similar genetic makeup. if you do not have a suitable matched sibling, an unrelated person with a similar genetic makeup may be used. Under some circumstances a parent or child who is only half matched can also be used. This is termed haploidential transplant. |
Allogeneic Transplant |
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What is the first intervention we want to do after a bone marrow transplant |
PREVENT INFECTION Wash hands use gloves Mask for the patient whenever they leave the room or if someone is sick. |
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We want to place a patient who has received a bone marrow transplant in _______ ______. Which means what is not allowed in their room? |
Neutropenic Precautions No fresh fruit or flowers All foods should be cooked until hot No raw veggies or fruits Water bottles only Any blood transfusion must be irradiated (WBC destroyed) |
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What are some side effects of the bone marrow transplant? |
Mucositis & Diarrhea Nausea and vomiting Loss of hair (temporary) Infertility -depends on treatment Secondary cancers (small risk usually develops 3-5 yrs after) |
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What is graft VS host disease? |
Occurs when the transplant you received is attacked by your body because its not your own. Happens with the allogeneic transplants *BIGGEST THREAT other than the underlying disease, to the success of a bone marrow transplant* |
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What should you do if your patient is experiencing Graft vs Host disease? |
High dose steroids- immune suprresion Cyclosplorin |
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What are the signs and symptoms of Graft vs Host disease? |
Skin rash, diarrhea, liver damage, or other problems depending on the organ affected. |
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Side effects of morphine? |
anaphylaxis, confusion constipation orthorstatic hypotension Respiratory distress |
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Nursing implications for morphine |
Assess pain and vital signs (especially respiration) before and after the dose. If given IV push, watch for respiratory depression, hypotension and vascular collapse |
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What are the side effects of albumin? |
Hypotension Fluid overload |
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What nursing implications do you want to do with Albumin |
Closely observe for fluid overload watch for anaphylactic reaction assess for therapeutic response |
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What are the side effects of Procrit? (epoetin) |
Hypertension Seizures HA ND Iron deficiency |
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Nursing implications for procrit? |
Monitor BP before erythropoietin therapy Do not shake solution because it may denature the glycoprotein Discard remaining contents because erythropoietin does not contain a preservative. Monitor HCT, serum iron, and fluid and electrolyte balance Monitor for seizures. (rapid increase of HCT increases risk) |
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Side effects of Iron supplements? |
Tarry stools Constipation N Epigastric pain Heartburn Seizures Anaphylaxis |
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What are some nursing implications when giving iron supplement? |
Do not give with antacids or tetracyclines Take vitamin C to promote absorption Liquid preparations stain teeth, use a straw |
