Nokea
A nurse is caring for a client undergoing treatment with plant alkaloids for cancer. The client is also receiving warfarin for a history of atrial fibrillation. The nurse would monitor the client for which of the following as a possible interaction?
- A. Increased risk of seizures
- B. Increased risk of ototoxicity
- C. Increased risk of CNS depression
- D. Increased risk of prolonged bleeding
Correct Answer: D
Rationale: The nurse should monitor the client for the increased risk of prolonged bleeding. Increased risk of seizures occurs when phenytoin interacts with a plant alkaloid. Increased risk of ototoxicity is observed in clients receiving plant alkaloids with loop diuretics. Increased risk of CNS depression is observed in clients who are receiving antidepressants along with plant alkaloids.
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A nurse is discussing the possible adverse reactions that may occur with antineoplastic therapy. Which of the following would the nurse discuss as examples of long-term adverse reactions?
- A. Fertility problems
- B. Thrombocytopenia
- C. Leukopenia
- D. Stomatitis
- E. Cardiotoxicity
Correct Answer: A,E
Rationale: Fertility problems, cardiotoxicity, pulmonary toxicity, and neurologic problems are examples of long-term reactions to an antineoplastic drug that the nurse should discuss with the client prior to drug administration. Thrombocytopenia, leukopenia, and stomatitis are more immediate adverse reactions.
A client has been receiving treatment with antineoplastic drugs that depress the bone marrow. Which preadministration assessment would be most important for the nurse to complete with respect to this effect?
- A. Evaluating the emotional response to the disease
- B. Obtaining a complete blood count
- C. Checking fluid intake and output
- D. Evaluating the client's understanding of therapy
Correct Answer: B
Rationale: The nurse should perform a complete blood count to provide baseline data for future reference. Emotional response to the disease, client understanding of therapy, and fluid intake and output are preadministration assessments not pertaining to the depressing effect of the bone marrow.
A nurse should understand that which of the following adverse effects of antineoplastic drugs are related to the death of rapidly growing cells?
- A. Alopecia
- B. Leukopenia
- C. Stomatitis
- D. Cardiotoxicity
- E. Thrombocytopenia
Correct Answer: A,B,C,E
Rationale: Alopecia, bone marrow suppression (Leukopenia and thrombocytopenia), stomatitis, and diarrhea are adverse effects of antineoplastic drugs and are related to the death of rapidly growing cells.
The nurse suspects that a client is developing leukopenia and notifies the primary health care provider based on assessment of which of the following?
- A. Temperature of 100.4°F or higher
- B. Cough
- C. Sore throat
- D. Frequent urination
- E. White blood cell count of less than 2500/mm³
Correct Answer: A,B,C,D,E
Rationale: The nurse should notify the physician immediately if any of the following occur during observation of a client receiving an antineoplastic drug as they may be signs of leukopenia: temperature of 100.4°F or higher, cough, sore throat, chills, frequent urination, or a white blood cell count of less than 2500/mm³.
Which of the following alkylating agents can cross the blood-brain barrier?
- A. Cisplatin (Platinol-AQ)
- B. Melphalan (Alkeran)
- C. Carmustine (BiCNU)
- D. Streptozocin (Zanosar)
- E. Mechlorethamine (Mustargen)
Correct Answer: C,D
Rationale: Nitrosoureas, like carmustine (BiCNU) and streptozocin (Zanosar), are alkylating agents that can cross the blood-brain barrier.