OCN Review Treatment Modalities
PIV indications - answer One time therapies (IV push)
Vesicants with ph < 5 or > 9 or osmolality 600 contraindicated
In situ for 96 hours
Midline Catheter (PIV) - answer Therapy for 1-4 weeks
General PIV guidelines (1) location - answer Distal site
Avoid impaired circulation, lymphedema,swelling,lymph node dissection, infection,
phlebitis, prev. Venipuncture 24 hours before
General PIV guidelines (2) - answer Avoid use if older than 24 hours, assess for
blood return and patency
PIV Phlebitis - answer Pain, erythema, edema
PIV infiltration - answer Leaking, cool skin, tightness, dec. infusion rate. Prevent by
using appropriate syringe sizes for blood draw
PIV extravasation - answer Redness, edema, pain, burning, no blood return Prevent:
frequent blood return during vesicant admin, stop infusion, aspirate residual drug, give
antidote, apply heat/cold
PIV infection - answer Fever, redness, erythema, warmth to extremity
CVL nontunneled - answer IJ, SCV, FV
CVL Tunneled - answer > 30 day use. Lower infection rate than nontunneled
IPORT - answer Use for long-term intermittent therapy. Use for blood transfusions,
poor peripheral access,
PICCs - answer AC vein, higher incidence of thrombosis. Contraindicated in history
of thromboses
Radiation Therapy OV - answer Ionizing radiation, damages dna, shrinks tumors,
kills cancer cells
RT type: External Beam - answer Most common, uses linear accelerator on
electrons
, Proton therapy - answer Uses cyclotrons or synchrotrons
Brachytherapy - answer Radioactive sources put inside patient. Sealed in needles,
seeds, wires, caths implanted directly or near tumor (temp or perm) Common for
prostate, uterus, cervix, breast
RT used after surgery - answer Adjuvant treatment
RT before surgery - answer Neoadjuvant or induction to improve cure rates, or make
surgery easier
Stereotactic Radiosurgery - answer Uses 3D imaging
Radioembolization. - answer Cuts off blood flow to a tumor
RT Palliative - answer Helps reduce pain and suffering in cx
RT Goals - answer Curative,
Control - prevent future cx growths
Palliation - help relieve sx like pain, dysphagia, dyspnea, bowel blockages
Short term/high dose Brachytherapy - answer Cx cells receive continuous low-dose
over several days
Removed after tx
Long-term/low dose Brachytherapy - answer Source is surgically sealed and left
even after all radiation is given off. No harm to patient
Systemic Radiation Therapy - answer Pt swallows or receives injec of radioactive
iodine or monoclonal antibody
Ibritumonab tiutexan - answer Tx Bcell NHL binds to protein on B lymphocytes
RT acute s/e - answer Occur during tx. Depends on area being treated, dose given
per day, total dose.
Damage rapidly dividing cells : skin cells, salivary glands, hair loss, diarrhea, cystitis,
n+v
RT chronic s/e - answer Salivary gland damage fatigue for weeks,months, bone
marrow suppression
Amifostine - answer Protects salivary glands from radiation damage
Late RT s/e - answer Fibrosis(scar tissue), damage to bowels, memory loss,
infertility, secondary cx depend on part of body where treated
PIV indications - answer One time therapies (IV push)
Vesicants with ph < 5 or > 9 or osmolality 600 contraindicated
In situ for 96 hours
Midline Catheter (PIV) - answer Therapy for 1-4 weeks
General PIV guidelines (1) location - answer Distal site
Avoid impaired circulation, lymphedema,swelling,lymph node dissection, infection,
phlebitis, prev. Venipuncture 24 hours before
General PIV guidelines (2) - answer Avoid use if older than 24 hours, assess for
blood return and patency
PIV Phlebitis - answer Pain, erythema, edema
PIV infiltration - answer Leaking, cool skin, tightness, dec. infusion rate. Prevent by
using appropriate syringe sizes for blood draw
PIV extravasation - answer Redness, edema, pain, burning, no blood return Prevent:
frequent blood return during vesicant admin, stop infusion, aspirate residual drug, give
antidote, apply heat/cold
PIV infection - answer Fever, redness, erythema, warmth to extremity
CVL nontunneled - answer IJ, SCV, FV
CVL Tunneled - answer > 30 day use. Lower infection rate than nontunneled
IPORT - answer Use for long-term intermittent therapy. Use for blood transfusions,
poor peripheral access,
PICCs - answer AC vein, higher incidence of thrombosis. Contraindicated in history
of thromboses
Radiation Therapy OV - answer Ionizing radiation, damages dna, shrinks tumors,
kills cancer cells
RT type: External Beam - answer Most common, uses linear accelerator on
electrons
, Proton therapy - answer Uses cyclotrons or synchrotrons
Brachytherapy - answer Radioactive sources put inside patient. Sealed in needles,
seeds, wires, caths implanted directly or near tumor (temp or perm) Common for
prostate, uterus, cervix, breast
RT used after surgery - answer Adjuvant treatment
RT before surgery - answer Neoadjuvant or induction to improve cure rates, or make
surgery easier
Stereotactic Radiosurgery - answer Uses 3D imaging
Radioembolization. - answer Cuts off blood flow to a tumor
RT Palliative - answer Helps reduce pain and suffering in cx
RT Goals - answer Curative,
Control - prevent future cx growths
Palliation - help relieve sx like pain, dysphagia, dyspnea, bowel blockages
Short term/high dose Brachytherapy - answer Cx cells receive continuous low-dose
over several days
Removed after tx
Long-term/low dose Brachytherapy - answer Source is surgically sealed and left
even after all radiation is given off. No harm to patient
Systemic Radiation Therapy - answer Pt swallows or receives injec of radioactive
iodine or monoclonal antibody
Ibritumonab tiutexan - answer Tx Bcell NHL binds to protein on B lymphocytes
RT acute s/e - answer Occur during tx. Depends on area being treated, dose given
per day, total dose.
Damage rapidly dividing cells : skin cells, salivary glands, hair loss, diarrhea, cystitis,
n+v
RT chronic s/e - answer Salivary gland damage fatigue for weeks,months, bone
marrow suppression
Amifostine - answer Protects salivary glands from radiation damage
Late RT s/e - answer Fibrosis(scar tissue), damage to bowels, memory loss,
infertility, secondary cx depend on part of body where treated
