Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
110 Cards in this Set
- Front
- Back
What is chemotherapy?
|
use of chemical drugs to destroy cancer cells
|
|
How does chemo fight cancer?
|
by interfering with cancer cells' ability to grow and duplicate
|
|
Chemo attacks which cells?
|
all rapidly dividing cells, both malignant and normal...harm to healthy cells is what causes side effects
|
|
Examples of normal cells that are OFTEN harmed by chemo are (4)?
|
bone marrow
digestive tract reproductive system hair follicles |
|
Chemo harm to normal cells of bone marrow causes (3)?
|
infection
bleeding energy loss |
|
Chemo harm to normal cells of the digestive tract causes (5)?
|
constipation
diarrhea mouth sores nausea vomiting |
|
Chemo harm to normal cells of the reproductive system causes?
|
temporary or permanent loss of reproductive ability or harm to developing fetus
|
|
Chemo harm to normal cells of the hair follicles causes?
|
temporary loss of body hair
|
|
The frequency and length of treatment will depend on which several factors?
|
type/site of cancer
chemotherapy drugs used how side effects are tolerated... how the body responds to treatments |
|
What routes is chemo administered by (6)?
|
oral
IV IM subcut venous access device applied on skin (the chemo should not hurt...some meds may cause a cool or burning sensation, but NEVER cause pain) |
|
What do side effects depend on?
|
drug dose
extent of disease physical status how body reacts route of delivery |
|
What is the most frequent TEMPORARY side effect of chemo?
|
bone marrow suppression
|
|
Where are blood cells produced?
|
bone marrow which is the spongy tissue filling in the center of the flat and long bones
ex: sternum vertebrae ribs skull |
|
Why is bone marrow suppression serious?
|
impairs ability of body to fight infection and clot blood
|
|
What is nadir?
|
the time during chemotherapy cycle when BLOOD count reaches its LOWEST point
Normal WBCs: 5,000 to 10,000 (when blood count is low, patient can continue most normal activities) |
|
When does nadir occur?
|
about 7-14 days after first day of chemo treatment
|
|
What are some illnesses a chemo patient should avoid?
|
colds
flu chicken pox cold sores |
|
What kind of recently administered vaccines clients should a chemo patient avoid?
|
live virus vaccines...live oral polio vaccine
|
|
All sources of stagnant water should be avoided including?
|
flower vase water
pitchers denture cups humidifiers respiratory equipment |
|
All raw fruits and vegetables should be washed thoroughly in case they are contaminated with?
|
bacteria...and wash hands thoroughly before eating...bathe or shower daily
|
|
Change the ____ litter box.
Avoid malls and waiting rooms. |
cat
|
|
Practice good oral hygeine by brushingn teeth after every meal...do not floss or brush teeth with a ______ _____ brush.
|
stiff bristle...this would allow germs to enter blood stream...mouth rinse is okay...check with doctor before having dental work done
|
|
Report physician immediately a fever above _______degrees F, after checking twice...use oral thermometer
|
100 degrees F
|
|
Tylenol okay for pain relief
|
okay
|
|
Protect hands from cuts and _____.
|
burns
|
|
Women should use _____ _____ instead of tampons?
|
sanitary napkins
|
|
Symptoms to report (9)?
|
chills
burning or frequency of urination headache or stiff neck any sores, open cuts or infected areas fever above 100 degrees F, after checking twice cough, sore throat or runny nose chest pain or shortness of breath sores or white patches in mouth loose, watery stools (diarrhea) |
|
What is normal hemoglobin?
|
12 to 18
|
|
What is normal hematocrit?
|
37 to 52
|
|
If cancer treatment causes anemia, patient may do the following?
|
take frequent rest periods
ask for help change positions slowly if dizziness experienced prioritize activities eat balanced diet ask doctor about Procrit or Aranesp for supportive therapy |
|
Report the following with chemo treatment?
|
dizziness
feeling as if heart is "pounding" or beating very fast ringing in ears shortness of breath unusual tiredness or weakness |
|
What is normal platelet count?
|
130,000 to 400,000
|
|
Nadir for platelets?
|
7 to 14 days after treatment
|
|
Chemo patients may prevent problems related to low platelets by?
|
avoiding physical activity
that could cause injury avoid toothpicks use caution with knives or tools shave with an electric razor Tylenol okay if doctor approves. Blow nose gently. Don't use enemas Supportive therapy for low platelets may include use of oprelvekin if doctor prescribes |
|
If bleeding occurs due to low platelet count, apply pressure to site for how long?
|
5 minutes...if bleeding lasts longer than 5 minutes, call doctor
|
|
What medication disrupts platelet function and should be avoided unless doctor prescribes?
|
aspirin
aspirin-containing medication |
|
If platelets are running low, report the following effects?
|
bleeding gums
blood in urine or stools easy bruising nose bleeds small red dots under skin (petechiae) prolonged bleeding from a cut |
|
What does a complete blood count (CBC) measure?
|
kinds of cells in blood
|
|
What does the Absolute Neutrophil Count (ANC) measure?
|
neutrophils, which fight infection and represent a subset of WBC
|
|
Red blood cells carry oxygen to the cells...which tests analyze it?
|
hemoglobin
hematocrit |
|
What do platelets do?
|
clot blood
|
|
What does a lowered (less than 1000) ANC or absolute neutrophil count reflect?
|
that bone marrow is recovering and new blood cells are beginning to grow and mature
|
|
What is there a risk for if ANC is less than 1000?
|
serious or fatal infection...patient's own normal bacteria rather than exogenous exposure
|
|
Take temperature four times daily. Contact medical staff immediately if a fever runs greater than _____ and ANC is less than ____.
Prompt hospitalization and initiation of IV antibiotic therapy is necessary to avoid life threatening infection |
100
1000 |
|
Excessive bleeding (nosebleeds, bruises, blood in stool) rarely occurs unless platelet count is under?
|
50,000
|
|
Platelet count should register over _____ to not be at risk for bleeding.
|
175,000
|
|
Normal WBC?
|
5,000 to 10,000
|
|
Expected WBC values during chemotherapy?
|
2,000 to 5,000
|
|
WBC danger values?
|
less than 1,000
|
|
Normal Absolute neutrophil count (ANC) values?
|
1,500 to 3,000
|
|
Expected ANC values during chemotherapy?
|
1,000 to 2,000
|
|
ANC danger values?
|
less than 1,000
|
|
Normal hemoglobin values?
|
12-18
|
|
Expected hemoglobin values during chemotherapy?
|
9-11
|
|
Danger values for hemoglobin?
|
less than 7
|
|
Normal values for hematocrit?
|
13-52
|
|
Expected values for hematocrit during chemo?
|
27-33
|
|
Danger values for hematocrit?
|
less than 20
|
|
Normal values for platelets?
|
130,000 to 400,000
|
|
Expected values for platelets during chemo?
|
75,000 to 175,000
|
|
Danger values for platelets?
|
less than 50,000
|
|
Most patients don't get ____ or have _____ if blood counts stay down for only a few days. Patient may still feel well.
|
infected
bleeding |
|
The most common and and potentially serious side effect of chemo is lowered ______ counts.
|
blood
|
|
Two agents used in bone marrow suppression supportive therapies include?
|
Neupogen (GCSF)
Neulasta |
|
Neupogen is administered how many days after chemo treatment as a bone marrow suppression supportive therapy?
|
7 to 14
|
|
Nuelasta is given ____ of or ____ after chemo treatment as a bone marrow suppression supportive therapy?
|
day
day |
|
The goal of bone marrow suppression supportive therapy is to stimulate production of falling ____ and reduce chances of _____.
|
wbcs
infection |
|
Medications that may increase RBCs are?
|
erythropoetin (Procrit)
Aranesp |
|
The goal of bone marrow suppression supportive therapy drugs such as erythropoetin (Procrit) and Aranesp is to stimulate production of RBCs which have decreased as a result of chemo and treat _____ which may have occurred as a result of chemo.
|
anemia
|
|
What drug and/or method might be used to improve platelet count?
|
oprevelkin
platelet transfusion |
|
Most _____ (killed or inactivated) do not represent a danger to immunocompromised patients.
|
vaccines
|
|
Patients undergoing chemo should not be given ____ vaccines.
|
live
|
|
If a chemo patient comes in contact with a recent _____ ______ recipient, observe strict personal hygeine (wash hands before eating, drinking, food preparation)
|
polio vaccine
|
|
How long may a polio virus vaccine recipient pass it in stools?
|
6 weeks
|
|
MMR (measles-mumps-rubella vaccine) is not ________.
|
contraindicated
|
|
During flu season, it is generally recommended to chemo patients to ______ flu and pneumonia vaccine.
|
receive
|
|
If constipation occurs while on chemo, it's okay to use a ____ ______
|
stool softener or laxatives
|
|
Have the patient report these 3 following symptoms of constipation due to some chemo?
|
any change in bowel pattern
no relief from symptoms severe abdominal pain |
|
Chemo patient should report the following symptoms of diarrhea to physician?
|
more than 6 watery bowel
movements per day blood in stool symptoms that persist for more than 24 hours or if diarrhea with pain and cramping loss of 5 lbs or more after diarrhea starts no urination for 12 hours or more |
|
Chemo patient may avoid bouts of mild to severe diarrhea by doing the following?
|
increase intake of cheese,
bananas, apple sauce, and white rice or cereal... eat small, frequent meals... stop eating nuts, whole grains, bran cereals, fresh fruits and raw vegetables avoid milk products speak with your nurse/dr regarding OTC meds |
|
Chemo patient may feel fear, anxiety, anger, depression so patient should report the following to health care (2)?
|
sleep disturbances
persistent feelings of sadness or hopelessness |
|
Chemo patients may be more sensitive to light or sun and can do the following to help?
|
sunglasses
artificial tears or eye lubricant can be used to assist with excessive tearing, blurred vision, and dry eyes change prescription eyewear after chemo course completed |
|
The following eye conditions may be experienced by chemo
patients...report the following (4)? |
eye infections
blind spots a sudden change in vision or blurring of vision pain |
|
Due to fatigue, report persistent ________
|
insomnia
|
|
Hair loss usually occurs how many weeks following first chemo treatment?
|
2-3 weeks...may experience scalp sensitivity...sleep on satin pillowcases
|
|
Report increase or decrease in weight of ____ lbs or more in one week or any major change in appetite
|
5
|
|
Chemo can damage the lining of the mouth causing small, painful _____ on tongue, lips, gums, and insides of cheeks...can become infected
|
ulcers
|
|
Mouth sores and ulcers can occur how many days after chemo start and can take how many weeks to heal.
|
5 to 12 days
2 to 3 weeks |
|
What therapy is recommended to lessen or prevent mouth sores?
|
oral cryotherapy (use of cold)
|
|
What is oral cryotherapy?
|
Five minutes before chemotherapy is given, place a spoonful of ice chips in mouth and swish it around...repeat for 30 minutes...remember to remove dentures first
|
|
What kind of foods and juices should not be eaten to avoid mouth stinging?
|
highly acidic
ex: tomatoes oranges grapefruit apricot pear nectar squash beans peas |
|
Avoid mouth irritants such as smoking, alcohol and rough foods like?
|
potato chips...use straw...brush teeth with soft bristle brush within 30 minutes of meal or bedtime
|
|
Avoid mouthwashes that contain?
|
alcohol...
mix 1/2 tsp salt with 8 oz. warm water to make own mouth-wash...consult doctor before having dental work done |
|
Antiemetics may be given orally, IV or rectally to prevent or decrease ___ and ____
|
nausea and vomiting
|
|
What are 3 different types of nausea and vomiting?
|
anticipatory
acute delayed |
|
What is anticipatory nausea and vomiting (ANV)?
|
occurs at the beginning of a new cycle of chemo in response to conditioned stimuli, such as sights and sounds of treatment room
|
|
What is acute nausea and vomiting?
|
occurs during the first 24 hours after chemo
|
|
What is delayed nausea and vomiting?
|
occurs more than 24 hours after chemo
|
|
To ease feeling of nausea and vomiting?
|
don't lie flat immediately
after eating drink carbonated beverages or take ice chips made with carbonated beverages... (if patient vomits more than 3 times an hour for more than 3 hours or cannot keep down meds, call doctor) |
|
Chemo patient experiencing peripheral neuropathy can protect peripheral extremities by what methods?
|
by wearing shoes or slippers, avoid exposure to extreme cold and heat...
do not use heating pads or hot water bottles |
|
7
|
pain as bad as it can be
|
|
6
|
extreme pain
|
|
5
|
severe pain
|
|
4
|
moderate pain
|
|
3
|
mild pain
|
|
2
|
slight pain
|
|
1
|
no pain
|
|
Chemo can cause skin problems such as?
|
redness
itching peeling dryness acne nails may become brittle and discolored (effects disappear once treatment is over...report any rash or persistent skin problem that does not go away) |
|
Food items to use for sore throat?
|
butter
margarine gravy sauces broth dunk foods in beverages use blender use straw eat soft foods report any throat soreness that interferes with nutritional or liquid intake or causes discomfort |
|
Chemo can cause changes in taste and smell sensations...things that can help?
|
substitute red meat for fish, chicken, eggs, tofu...
try cold foods like milk- shakes, cold cuts, tuna fish, egg salad... adding sugar can mask flavor of salty foods and adding salt can decrease the sweetness of sugary foods..try stronger seasonings such as cayenne and curry... if food tastes metallic, use plastic utensils and dishes..tart foods may also overcome metallic taste...try citrus juices, cranberry juice, pickles or relish... try sugar-free candies or gum to eliminate bad taste; fresh fruits also help... marinate food in wine, fruit juice, beer, soy sauce, butter, or b-b-q sauce |