Cancer Treatment

Question 1

cachexia

Answer 1

body wasting d/t malnutrition

Question 2

cachexia causes

Answer 2

CINV, mucositis, ulcers, thrush, anorexia, altered taste

Question 3

external radiation

Answer 3

pt is NOT radioactive, no danger to others

Question 4

internal radiation

Answer 4

pt is radioactive, risk to others until removed

Question 5

rad side effects

Answer 5

radiation dermatitis, risk of secondary malignancies, systemic side effects

Question 6

radiation dermatitis

Answer 6

redness, rash, desquamation- dry, itchy, prone to breakdown

Question 7

skin pro w rad

Answer 7

wash qday w/ water & gentle soap, rinse thoroughly, use hands not washcloth, use prescribed products, avoid sun exposure

Question 8

systemic SE of rad

Answer 8

altered taste, fatigue, bone marrow suppression

Question 9

nadir

Answer 9

point when bone marrow activity & WBC are lowest - highest risk of infection

Question 10

chemo doses

Answer 10

based off height & weight - update often since weight loss is side effect

Question 11

chemo admin through central

Answer 11

check for blood return - high extravasation risk

Question 12

chemo admin safety

Answer 12

PPE, double sign off

Question 13

chemo admin PPE

Answer 13

mask, face shield/goggles, gown, chemo gloves or double glove - at least 48 hours after

Question 14

oral chemo considerations

Answer 14

just as toxic - PPE
DNC, split, break, or chew

Question 15

bone marrow suppression causes

Answer 15

pancytopenia

Question 16

filgrastim, peg filgrastim

Answer 16

monitor WBC & ANC, can cause bone pain

Question 17

Epogen alfa, darbepoetin

Answer 17

monitor RBC

Question 18

Epogen alfa & darbepoetin SE

Answer 18

bone pain, headache, n/v, dizziness, fatigue, swelling

Question 19

CINV meds

Answer 19

dexamethasone, lorazepam, metoclopramide, aprepitant, ondansetron

Question 20

mucositis care

Answer 20

thorough oral assessment, clean & well fitting dentures, no mouthwash w alc - rinse w baking soda or salt water, no tobacco/alc

Question 21

what foods should mucositis pts avoid

Answer 21

spicy, salty, acidic, dry, hard/crunchy foods
nothing too hot

Question 22

alopecia pt teaching

Answer 22

it will grow back - may look different; keep protected in summer, wear hat to keep warm in winter

Question 23

chemo brain s/s

Answer 23

reduced concentration, difficulty learning new info, memory loss, confusion

Question 24

chemo brain tx

Answer 24

stay physically active, read books, take meds

Question 25

sepsis

Answer 25

severe bloodstream infection

Question 26

sepsis s/s

Answer 26

in neutropenic pt - only low grade fever

Question 27

sepsis tx

Answer 27

cultures, broad spectrum abx

Question 28

DIC

Answer 28

abnormal clotting --> hemorrhage

Question 29

DIC complications

Answer 29

organ failure, hypovolemic shock/death, stroke, pain

Question 30

SIADH

Answer 30

water retention

Question 31

SIADH s/s

Answer 31

FVO - bounding pulses, weight gain, increased BP, crackles, confusion, hyponatremia

Question 32

hyponatremia s/s

Answer 32

mild - weakness, cramping, anorexia severe - seizure coma death

Question 33

spinal cord suppression s/s

Answer 33

depends on level back pain, weakness, unsteady gait, loss of sensation retention, constipation, sudden incontinence - go to ED immediately

Question 34

spinal cord suppression tx

Answer 34

high dose corticosteroids, rad/chemo, back brace

Question 35

hypercalcemia s/s

Answer 35

early - anorexia, polyuria, bone pain, kidney stones severe - ECG changes, ileus, muscle weakness, dehydration

Question 36

hypercalcemia tx

Answer 36

IV hydration w loop diuretics, bisphosphonates/calcitonin, dialysis

Question 37

superior vena cava syndrome

Answer 37

congestion of blood

Question 38

SVCS s/s

Answer 38

edema & erythema of face, neck upper chest SOB, stridor

Question 39

SVCS tx

Answer 39

depends on cause - anticoag if clot remove cath if from central rad/chemo if tumor

Question 40

tumor lysis syndrome (TLS)

Answer 40

tumor cells destroyed rapidly - contents released into bloodstream

Question 41

TLS s/s

Answer 41

AKI or dysrhythmias - hyperK, hyperP, high uric acid

Question 42

TLS tx

Answer 42

hydration & diuretics allopurinol - prevents kidney stones