Administration – Test Questions And Correct Answers –
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Hematologic cancer (blood cancer)
-cancer that begins in bone marrow or immune system cells.
-Ex: leukemia, lymphoma, multiple myeloma
Leukemia
cancer starts in blood-forming tissues like bone marrow
-causes lots of abnormal blood cells to be produced and enter bloodstream
Lymphoma
-cancer that begins in immune system (WBC=lymphocytes)
-hodgkin and non-hodgkins
-B lymphocytes (B cells) - make antibodies (bacteria and viruses, most common
lymphoma
-T lymphocytes (T cells) - boost/slow immune, destroy germs and abnormal cells
Hodgkin lymphoma
Reed-Sternberg cell (cancer cells in classic)
-typically starts in B cells
Non-Hodgkin's Lymphoma
-large, diverse group of cancers in immune system cells
-indolent (slow growing) or aggressive (fast)
Myeloma
Cancer in plasma cells (WBC that produce antibodies)
Chemotherapy
All antineoplastic agents used to treat cancer, given through oral and parenteral routes
or other routes as specified in the standard, not including hormonal therapies.
Who can order chemotherapy?
Written and signed by licensed independent practitioners (MD/DO, PA, Oncology NP)
Can you use verbal orders for chemotherapy?
NO! Only when holding/stopping admin.
Who can mix Chemotherapy?
Pharmacist, Pharmacy tech, MD/DO, qualified RN
Who can administer chemotherapy?
Registered Nurses with specialized education, prep and training. See specific state laws
and statutes
How often is chemo competency reassessed>
Annual continuing ed and competency assessment is recommended
What is the dose verification process?
-confirm plan with patient
-two practitioners verify: drug name, dose, volume, rate, route, expiration date,
appearance
-document verification in chart
What PPE is required for IV Chemotherapy?
, -Gloves: two pairs, HD tested
-Gown: disposable, back closed, long sleeved
-Respirator: NIOSH approved
-Eye & Face: face shield/mask
Neoadjuvant therapy (tumor burden)
Chemo BEFORE primary treatment (common in breast and colon)
Adjuvant therapy
Chemo AFTER primary treatment (common in solid tumor)
Bone Marrow
soft, sponge-like tissue in center of most bones, produce WBC, RBC, and platelets.
Myelosuppression
bone marrow activity is decreased, causing less RBC, WBC and Platelets.
Myeloablation
severe myelosuppression
Induction phase
initial phase, typically in hospital, intended myelosuppression
Consolidation phase (intensification/postremission therapy)
after successful induction, kills cancer cells left in body (ex radiation, stem cell
transplant)
Synergy
when one chemo drug helps another work better at the same time
Complete response
no identifiable cancer present for at least one month or longer
Partial response
Measurable tumor reduced by 50% for at least one month with no new tumors
Stable disease
Tumor size reduced by less than 50% or less than 25% increase in growth
Progressive disease
tumor growth more than 25% or new cancer
What are the phases of the cell cycle?
-G1 phase
-S phase
-G2 phase
-M phase
What happens in G1 phase?
The cell increases in size and prepares to replicate its DNA.
What do chemo drugs do to target S phase?
Prevent cell from making DNA and/or RNA (replicating)
(ex: antifolates (methotrexate), antipyrimidines (5-fu), antipurines (hydroxyurea))
What do chemo drugs do to target G2 phase?
Cells prepare to divide, chemo drugs stop development of elements needed for cell
division
(ex: topoisomerase I and II inhibitors, bleomycin)
What do chemo drugs do to target M phase?