Chemotherapy

Which types of drugs are used to kill cancer cells?

antineoplastic drugs

What is combination therapy?

radiation + chemo

What are the two main types of antineoplastic agents?

cell-cycle specific + cell-cycle non-specific

Which drug is commonly used to treat or prevent breast cancer?

tamoxifen

Chemo precautions

• chemo gown

• two pairs of chemo gloves

• goggles and/or mask

How should you dispose of chemotherapy?

yellow rigid waste container or yellow chemo waste bag, then wash hands w/ soap and water

What is a lifeport?

a port under the skin that leads to the superior VC

What is a vesicant?

an irritant drug that can cause blistering and necrosis if it leaks out of the vessel

Stomatitis

mouth blistering/canker sores

Mucositis

mouth + GI tract blistering/canker sores

Which solution is often used to help with mucositis/stomatitis?

hydrogen peroxide in water (to numb the mouth)

Why is constipation commonly a problem in patients taking chemotherapy?

chronic opioid use

Nadir

the lowest point that a cell count can drop

When is the highest risk of infection for chemo patients?

5-7 days after each chemo dose (due to the lowest point of WBCs)

How is neutropenia assessed?

ANC

What is a normal ANC range?

2500+

What is the #1 cause of cancer-related deaths?

neutropenia

TRUE or FALSE: you should immediately call the provider with any small temperature elevation.

true

TRUE or FALSE: visitors are not allowed for chemo patients to prevent infection risk.

false (BUT they should be limited!!)

How often should dressings and IV tubing be changed for chemo patients?

daily

How often should oral care be performed for chemo patients?

4x daily

What are some general precautions for chemo patients?

• limit visitors

• no gardening or cleaning up after pets

• wear a mask in public

• frequent oral care

• drink only fresh water

Neutropenic precautions

• private room w/ door kept closed + posted sign

• antimicrobial soap (for handwashing)

• no invasive procedures (e.g. IM injections, rectal exams)

• avoid indwelling catheters or NG tubes if possible

• limit acetaminophen use

Why should acetaminophen be limited for chemo patients?

it can mask a fever

Which drug is used to prevent neutropenia + build up WBCs in cancer patients?

filgrastim

Which signs of thrombocytopenia should be reported?

headache, LOC changes, + pupil changes

What is the treatment for thrombocytopenia?

give platelets

When is a blood transfusion indicated?

Hgb below 8 and Hct below 24%

Normal Hgb level

12-18

Normal Hct level

35-50%