Antineoplastic Agents

Antineoplastic Agents 1. When describing the various effects of antineoplastic agents, the nurse explains that antineoplastic drugs primarily affect human cells that are rapidly multiplying, going through each cell cycle quickly. The nurse would identify which cells as an example? a. Skin i. Breast cells, cells of the testicles and ovaries proceed very slowly through the cell cycle. 2. How can a nurse best prevent tissue damage caused by an antineoplastic extravasation? a. Inspect the site frequently for redness or swelling. i. Site inspection is a major intervention for preventing extravasation. Use distal veins, avoid small veins in hands and wrists. Infusion pumps continue to administer the drug under pressure, leading to severe extravasation. 3. The nurse may be asked to administer which medications to a client to counteract the increase in uric acid and subsequent hyperuricemia resulting from the metabolic waste buildup from rapid tumor lysis? a. Allopurinol i. Allopurinol counteracts the increase and subsequent hyperuricemia resulting from metabolic waste buildup from rapid tumor lysis. ii. Amifostine binds with metabolites of cisplatin to protect the kidneys from nephrotoxic effects and reduces xerostomia. iii. Mesna binds with metabolites of ifosfamide to protect the bladder from hemorrhagic cystitis. iv. Leucovorin provides folic acid to cells after methotrexate administration. 4. A client asks the nurse what cancer cell growth is called. What would the nurse tell the client? a. Proliferation 5. A female client prescribed methotrexate for meningeal leukemia is asking about adverse effects of the drug. What would the nurse tell this client should be avoided when taking methotrexate? a. Pregnancy i. Antimetabolites are contraindicated for use during pregnancy and lactation because of the potential severe effects on the fetus and neonate. 6. Which antineoplastic drugs are classified as antineoplastic antibiotics? SATA Antineoplastic Agents a. Dactinomycin b. Daunorubicin c. Bleomycin i. Antineoplastic antibiotics have similar action to alkylating drugs. 7. A client is diagnosed with a brain tumor. The client is told that the cancer cells proliferate. The client asks the nurse what this means. What is the nurse’s best response? a. “The proliferation is the growth of cancer cells and the rate of growth.” 8. A patient has just received the first dose of imatinib and the nurse on the oncology unit is amending the patient’s care plan accordingly. What nursing diagnosis is most appropriate of this addition to the patient’s drug regimen? a. Risk for infection related to bone marrow suppression. i. Imatinib causes bone marrow suppression (like many cancer treatments) and creates a risk of infection. 9. A female patient is taking oral cyclophosphamide therapy for breast cancer. Because of potential adverse effects of the drug, the nurse will instruct the patient to: a. Drink a lot of water. i. An adverse effect of this drug is the incidence of hemorrhagic cystitis. The nurse should encourage the patient to drink at least 2 liters of fluid a day and in high-dose therapy, administer the cryoprotectant agent Mesna. Therapy should include pre-hydrating the patient orally and intravenously with at least 2 liters of normal saline solution. Potassium and magnesium additives may be indicated. The nurse will monitor urine output vigilantly to ensure an output of at least half of the intake. 10. A postmenopausal woman with breast cancer will most likely be treated with which antiestrogen drug? a. Tamoxifen i. Anti-estrogens are first line therapy for treating breast cancer in postmenopausal women. 11. A female client is ending an extensive chemotherapeutic regimen that included cytotoxic antineoplastic drugs. What does the nurse understand about bone marrow toxicity in the client? Antineoplastic Agents a. It is a common adverse effect of her treatment. i. Traditional cytotoxic antineoplastic drugs are nonselective in their effect on proliferating cells. Bone marrow toxicity is a common adverse effect of many cytotoxic drugs. ii. These drugs kill the same fraction of cells with each cycle of chemotherapy treatment. Repeated cycles of cytotoxic drugs potentially lower the number of cancer cells to a level where a person’s immune responses can take over and destroy the remaining cancer cells. 12. Which would the nurse identify as an antineoplastic antibiotic? a. Mitomycin i. Teniposide, vinblastine and docetaxel are mitotic inhibitors. 13. Which would the nurse expect to administer to counteract the effects of methotrexate? a. Leucovorin i. Leucovorin is administered to counteract the effects of treatment with methotrexate. ii. Alprazolam, metoclopramide and aprepitant are used to help alleviate the nausea and vomiting associated with chemotherapy. 14. A male client is diagnosed with prostate cancer. The treatment modality of choice includes both surgery and chemotherapy. What does the chemotherapeutic option include? a. Hormonal therapies i. Hormonal therapies that block effects of estrogen (in an estrogen-responsive tumor) and androgen (in an androgen-responsive tumor), respectively are essential in the treatment of breast and prostate cancers. 15. A client on the oncology unit has begun chemotherapy with a regimen that includes bendamustine. The client has begun to experience alopecia. The nurse should prioritize assessments related to what potential nursing diagnosis? a. Disturbed body image. i. The physiologic consequences of alopecia are usually inconsequential. 16. A client’s chemotherapeutic regimen includes procarbazine. What is the client’s most likely diagnosis? a. Hodgkin lymphoma Antineoplastic Agents i. Procarbazine (Matulane) is used in combination therapy for treatment of stages III and IV of Hodgkin disease. 17. A client has been diagnosed with a brain tumor and is dealing with this diagnosis by seeking detailed information about cancer. The nurse would explain to the client that the cancer is essentially a result of the disruption of what? a. Cell cycle. i. Malignant cells have lost the normal genetic regulation that controls cell growth, invading normal tissues and taking blood and nutrients away from them. In essence, the cell cycle has been pathologically disrupted. 18. A 49yo client is diagnosed with ovarian cancer. What is a characteristic of malignancy that differentiates them from normal body cells? a. Cancerous cells grow in an uncontrollable fashion. i. Malignant cells have lost the normal genetic regulation that controls cell growth, invading tissues and taking blood and nutrients away. They grow in an uncontrolled fashion without regard to growth regulation signals that stop the growth of normal cells. Cancerous cells have a finite life span and need energy. 19. An adult client has recently begun cancer treatment with methotrexate (MTX). When reviewing the client’s lab work, the nurse should consequently prioritize assessment of what? a. BUN and creatinine. i. The antimetabolites may also be nephrotoxic. MTX use in clients with impaired renal function leads to accumulation of toxic amounts or additional renal damage. Evaluation of the client’s status should take place before and during MTX therapy. This adverse effect of MTX treatment supersedes the importance of electrolytes and ABGs, though they would also be considered. 20. The nurse is describing the necessity of recovery periods between treatment cycles to a client receiving chemotherapy. How should the nurse best explain the need? a. Time is needed to replace many of the healthy body cells killed by chemotherapy. Antineoplastic Agents i. Cyclic administration involves taking the drugs for a specific period, with a recovery period following each treatment cycle. The recovery period allows time for the client to produce healthy cells to replace the normal rapidly dividing cells that have been affected by the drugs. 21.