Nokea
A nurse is caring for a client who is at risk for erythema during antineoplastic drug therapy. The nurse identifies a nursing diagnosis of Impaired Tissue Integrity. Which of the following would be appropriate to suggest?
- A. Scrub and clean skin often.
- B. Wear loose protective clothing.
- C. Ensure adequate sunlight.
- D. Have frequent baths.
Correct Answer: B
Rationale: The nurse should suggest to the client to wear loose protective clothing and to watch areas of skinfolds for breakdown. The nurse should not suggest that the client scrub and clean the skin often, ensure adequate sunlight, or have frequent baths as these measures may aggravate the condition and cause further impairment to the tissue. The client is advised to avoid sunlight.
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A nurse should monitor a client closely for increased seizure activity when which of the following antineoplastic drugs are used concomitantly with phenytoin (Dilantin)?
- A. Mercaptopurine (Purinethol)
- B. Busulfan (Busulfex)
- C. Thiotepa (Thioplex)
- D. Doxorubicin (Doxil)
- E. Irinotecan (Camptosar)
Correct Answer: B,C,E
Rationale: Plant alkaloids (irinotecan) and alkylating agents (busulfan and thiotepa) can increase risk of seizure when given with phenytoin (Dilantin).
Which of the following cytoprotective agents can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects?
- A. Allopurinol (Zyloprim)
- B. Amifostine (Ethyol)
- C. Leucovorin (Wellcovorin)
- D. Mesna (Mesnex)
- E. Dexrazoxane (Zinecard)
Correct Answer: A,B,C,D,E
Rationale: Allopurinol (Zyloprim), amifostine (Ethyol), leucovorin (Wellcovorin), mesna (Mesnex), and dexrazoxane (Zinecard) are cytoprotective agents that can be given along with antineoplastic drugs to help prevent or lessen certain adverse effects.
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.
After teaching a group of nursing students about antineoplastic drugs, the instructor determines that the teaching was successful when the students identify which of the following as being classified as a plant alkaloid?
- A. Vincristine (Oncovin)
- B. Capecitabine (Xeloda)
- C. Paclitaxel (Taxol)
- D. Etoposide (Toposar)
- E. Irinotecan (Camptosar)
Correct Answer: A,C,D,E
Rationale: Drugs that are derived from plant alkaloids include vinca alkaloids (vincristine), taxanes (paclitaxel), podophyllotoxins (etoposide), and camptothecin analogs (irinotecan). Capecitabine is an antimetabolite.
A nurse is caring for a client who is prescribed Velban, a vinca alkaloid. The client asks the nurse about how the drug acts. Which of the following would the nurse integrate into the response?
- A. Interference with amino acid production in the S phase.
- B. Stoppage of cells during the S and G2 phases.
- C. Inhibition of DNA synthesis during the S phase.
- D. Prevention of cell division during the S and G2 phases
Correct Answer: A
Rationale: Vinca alkaloids interfere with amino acid production in the S phase. Podophyllotoxins stop the cells and prevent cell division during the S and G2 phases. Camptothecin analog drugs inhibit DNA synthesis during the S phase.