Nursing III Exam 1 Study
Guide
Professional Nursing III Exam 1
Study
Guide
Oral cancer
meds
Precaution Oral drugs are more convenient for the patient and
s-
can be taken at home. However, there are many problems with
oral anticancer drugs. One of the biggest problems is the
misperception by patients and nononcology nurses that these
drugs are less toxic than IV chemotherapy, which is not true.
Oral anticancer drugs are just as toxic to the patient taking the
drug and to the person handling the drug as are standard
chemotherapy drugs. The responsibility for administering these
drugs often shifts from the oncology clinic to the home or to
nononcology acute care settings, and issues of protection,
correct administration, adherence, and recognition and
management of side effects are major concerns. There is a
critical need for patient education and support to self-manage
this therapy, including the accidental ingestion by another
person. Not all patients are able to accept the responsibility of
self-management, and this must be considered during patient
selection for oral chemotherapy
How to administer- Because these oral agents can be absorbed
through skin and mucous membranes and exert toxic effects, the
person who handles and administers them needs to use PPE in
the same way as during IV chemotherapy administration. This
becomes a more critical issue when nononcology nurses are
administering the drugs. The ONS practice guidelines stress
nurse education for competence to administer these drugs. All
nurses administering these drugs must know the indications for
drug use, dosage ranges, side effects and adverse effects,
schedules, and specific precautions. Oral agents must not be
crushed, split, broken, or
chewed. These drugs are biohazardous and must be discarded in
accordance with agency policy. Teach patients or whoever
prepares the dosages how to avoid touching the drugs. Tablets
and capsules in blister packs are pressed into a small paper cup.
Those in traditional medication bottles are “poured” first into
the bottle cap and then into a paper cup. The patient then
“drinks” the tablet/capsule from the cup into his or her mouth.
These drugs are to be taken separately from all other drugs.
, Nursing III Exam 1 Study
Guide
Consult a drug handbook or a pharmacist for timing of the drug
in relation to meals and what to do if a dose is missed. For many
of these oral drugs, missed doses are not taken when
remembered. The patient just takes the next scheduled drug
dose.
Oncology Emergencies
Spinal cord compression- tumor is pressing on the
spinal cord. weakness, pain, neuropathy
s/
: surgery
Intervent
Superior Vena Cava syndrome- happens w/ head and neck
tumors, lymphomas, especially if in the chest. ( lung and
breast cancers).
D : CT & MRI to diagnose
Intervent : stent superior vena cava
S/ pain, edema in the face, neck and arms,
cyanosis, SOB SIADH- causes hyponatremia
Hypercalcemia: increased calcium, happens in 1/3 of
patients w/ cancer.
Intervention: hydration, steroids. May have dialysis if the
patient has kidney disease.
Neutropenia- patient may have a fever. Patient is
immunosuppressive.
Thrombocytopenia- decreased number of platelets (increased risk
of bleeding) give oprelvekin
Low hemoglobin- give epoetin alfa
Guide
Professional Nursing III Exam 1
Study
Guide
Oral cancer
meds
Precaution Oral drugs are more convenient for the patient and
s-
can be taken at home. However, there are many problems with
oral anticancer drugs. One of the biggest problems is the
misperception by patients and nononcology nurses that these
drugs are less toxic than IV chemotherapy, which is not true.
Oral anticancer drugs are just as toxic to the patient taking the
drug and to the person handling the drug as are standard
chemotherapy drugs. The responsibility for administering these
drugs often shifts from the oncology clinic to the home or to
nononcology acute care settings, and issues of protection,
correct administration, adherence, and recognition and
management of side effects are major concerns. There is a
critical need for patient education and support to self-manage
this therapy, including the accidental ingestion by another
person. Not all patients are able to accept the responsibility of
self-management, and this must be considered during patient
selection for oral chemotherapy
How to administer- Because these oral agents can be absorbed
through skin and mucous membranes and exert toxic effects, the
person who handles and administers them needs to use PPE in
the same way as during IV chemotherapy administration. This
becomes a more critical issue when nononcology nurses are
administering the drugs. The ONS practice guidelines stress
nurse education for competence to administer these drugs. All
nurses administering these drugs must know the indications for
drug use, dosage ranges, side effects and adverse effects,
schedules, and specific precautions. Oral agents must not be
crushed, split, broken, or
chewed. These drugs are biohazardous and must be discarded in
accordance with agency policy. Teach patients or whoever
prepares the dosages how to avoid touching the drugs. Tablets
and capsules in blister packs are pressed into a small paper cup.
Those in traditional medication bottles are “poured” first into
the bottle cap and then into a paper cup. The patient then
“drinks” the tablet/capsule from the cup into his or her mouth.
These drugs are to be taken separately from all other drugs.
, Nursing III Exam 1 Study
Guide
Consult a drug handbook or a pharmacist for timing of the drug
in relation to meals and what to do if a dose is missed. For many
of these oral drugs, missed doses are not taken when
remembered. The patient just takes the next scheduled drug
dose.
Oncology Emergencies
Spinal cord compression- tumor is pressing on the
spinal cord. weakness, pain, neuropathy
s/
: surgery
Intervent
Superior Vena Cava syndrome- happens w/ head and neck
tumors, lymphomas, especially if in the chest. ( lung and
breast cancers).
D : CT & MRI to diagnose
Intervent : stent superior vena cava
S/ pain, edema in the face, neck and arms,
cyanosis, SOB SIADH- causes hyponatremia
Hypercalcemia: increased calcium, happens in 1/3 of
patients w/ cancer.
Intervention: hydration, steroids. May have dialysis if the
patient has kidney disease.
Neutropenia- patient may have a fever. Patient is
immunosuppressive.
Thrombocytopenia- decreased number of platelets (increased risk
of bleeding) give oprelvekin
Low hemoglobin- give epoetin alfa
