Preparation and handling of chemotherapy agents

Preparation and handling of chemotherapy agents May pose an occupational hazard Drugs may be absorbed through Skin Inhalation during preparation, transportation, and administration Only properly trained personnel should handle cancer drugs Chemotherapy methods of administration Oral More available options today Storage and side effects IM – Intramuscular IV – Intravenous (most common) Central venous access […]

Respiratory System : Cardiovascular System : Biochemical : Psychoemotional : Cancer

Respiratory System Pneumonitis Radiation pneumonitis develops 2-3 months after start of treatment. After 6-12 months, fibrosis occurs and is evident on x-ray. Side effect of some chemotherapy drugs. Monitor for dry, hacking cough; fever; and exertional dyspnea. Cardiovascular System Pericarditis and Myocarditis Inflammation secondary to radiation injury. Complication when chest wall is irradiated. May occur […]

Nervous System : Cancer

Nervous System Intracranial Pressure May result from radiation edema in central nervous system. Monitor neurologic status. May be controlled with corticosteroids. Peripheral Neuropathy Paresthesias, arelexia, skeletal muscle weakness, and smooth muscle dysfunction can occur as a side effect of plant alkaloids, taxanes, and cisplatin Monitor for these manifestations in patients on these drugs. Consider temporary […]

Genitourinary Tract : Cancer

Genitourinary Tract Hemorrhagic Cystitis Cells lining bladder are destroyed by chemotherapy (e.g., cyclophosphamide, ifosfamide). Side effect of radiation when located in treatment field. Encourage increased fluid intake 24-72 hr after treatment as tolerated. Monitor manifestations such as urgency, frequency, and hematuria. Administer cytoprotectant agent (mesna [Mesnex]) and hydration. Administer supportive care agents to manage symptoms […]

Integumentary System : Cancer

Integumentary System Alopecia Destruction of hair follicles by chemotherapy or radiation to scalp. Hair loss usually is temporary with chemotherapy, but usually permanent in response to radiation. Suggest ways to cope with hair loss (e.g., hair pieces, scarves, wigs). Cut long hair before therapy. Avoid excessive shampooing, brushing, and combing of hair. Avoid use of […]

Hematologic System : Cancer

Hematologic System Anemia Bone marrow depressed secondary to therapy. Malignant infiltration of bone marrow by cancer. Monitor hemoglobin and hematocrit levels. Administer iron supplements and erythropoietin. Encourage intake of foods that promote RBC production Leukopenia Depression of bone marrow secondary to chemotherapy or radiation therapy. Infection most frequent cause of morbidity and death in cancer […]

Gastrointestinal System : Cancer

Etiology Effects Nursing managements Gastrointestinal System Stomatitis, Mucositis, Esophagitis Epithelial cells are destroyed by chemotherapy or radiation treatment when located in field (e.g., head and neck, stomach, esophagus). Inflammation and ulceration occur due to rapid cell destruction. Assess oral mucosa daily and teach patient to do this. Encourage nutritional supplements (e.g., Ensure, Carnation Instant Breakfast) […]

Chemotherapy

Chemotherapy Antineoplastic therapy Use of chemicals given as a systemic therapy for cancer Mainstay for most solid tumors and hematologic cancers Can offer cure, control, or palliative care Cure Burkitt’s lymphoma Wilms’ tumor Neuroblastoma Acute lymphocytic leukemia Hodgkin’s lymphoma Testicular cancer Control Breast cancer Non-Hodgkin’s lymphoma Small cell lung cancer Ovarian cancer Palliation Relieve pain […]

Cancer treatment

Cancer treatment Surgical therapy Oldest form of cancer treatment Meets a variety of goals Trend is toward less radical surgeries Role of surgery in cancer treatment Prevention Removal of non-vital organs to prevent cancer Diagnosis Biopsy Palliation of symptoms Relief of pain Obstruction Hemorrhage Rehabilitation Reconstructive surgery Determine the diagnostic and treatment plan Clinical staging […]

Cancer: Interprofessional Care and Complications

Cancer: Interprofessional Care and Complications Cancer treatment goals Goals Cure therapy Surgery alone or periods of adjunctive systemic therapy Timeframe to “cure” may differ according to the tumor and its characteristics Control therapy Initial course and maintenance therapy Palliation therapy Palliation goal Relief or control of symptoms Maintain quality of life Palliative care and treatment […]