Term
| What is the formula for calculating BSA? |
|
Definition
| height (cm) X weight (kg) divided by 3600 then get the square root of that number. Round to the hundreth |
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Term
| What are the special instructions for donning gloves when giving chemo? |
|
Definition
| double glove: one under the chemo gown one over |
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Term
Give the normal lab values for the following labs. (Values for Children's Oncology)
WBC
Hgb
Hct
Platelets |
|
Definition
WBC: 4.5 - 14.5 (thousand)
Hgb: 11.5 - 15.5
Hct: 35 - 45%
Platelets: 140-440 thousand |
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Term
What is a normal ANC?
What is considered severe neutropenia? |
|
Definition
normal is >1500
severe neutropenia is <500 |
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|
Term
|
Definition
| add the percentage of segmented neutrophils (segs) to the percentage of immature neutrophils (bands) and multiply this by the WBC to the thousand |
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|
Term
| Why does chemo cause bone marrow suppression? |
|
Definition
| chemo kills rapidly dividing cells like those produced in the bone marrow |
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|
Term
| Bone marrow suppression can lead to any or all of what 3 conditions? |
|
Definition
| thrombocytopenia, anemia, leukopenia |
|
|
Term
| Define thrombocytopenia, anemia, leukopenia, and pancytopenia. |
|
Definition
thrombocytopenia: low platelet count
anemia: low Hgb/Hct
leukopenia: low WBC
pancytopenia: depression of all 3 cell lines |
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Term
| What are the nursing interventions for stomatitis? |
|
Definition
-provide ALCHOHOL FREE mouth washes
-encourage a bland diet
-use toothettes
-pain meds |
|
|
Term
| What are the nursing interventions for neutropenia? |
|
Definition
-GOOD HAND HYGEINE
-oral care
-avoid skin breakdown
-no sick visitors
-encourage good nutrition and rest
-VS q4 or more if needed
-notify for temp >101
-change IV tubing per protocol
-NO RECTAL TEMPS OR SUPPOSITORIES
-sterile prep for all procedures
(finger sticks, meds, tubing changes)
-avoid catheters
-dressing changes per protocol |
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|
Term
| What are the nursing interventions for thrombocytopenia? |
|
Definition
-no IM injections
-no aspirin or ibuprofen
-soft toothbrushes; no flossing
-apply pressure to venipuncture sites
-stool softeners
-no rectal temps or suppositories
-check stools for blood
-use electric razors
-observe for bruising
-avoid invasive procedures
-control menses
-do not dislodge clots
-no contact sports |
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|
Term
| Adriamycin is also known as? |
|
Definition
|
|
Term
| How is Adriamycin administered? |
|
Definition
| IV infusion 30 min to 96 hrs via CVL or IVP |
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|
Term
| What are the possible side effects of Adriamycin? |
|
Definition
| cardiotoxicity, vesicant, stomatitis, red/orange urine, hyperpigmentation of the nailbeds or skin creases, radiation recall |
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|
Term
| What is the nursing care for Adriamycin? |
|
Definition
| infuse only through a CVL for IV infusions, check for blood return at the beginnning and end of infusion as well as q 2-4, check site q 1 for signs of infiltration, flush line until it is totally cleared following infusion, if loss of blood return stop infusion and evaluate |
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|
Term
| How is Vincristine administered? |
|
Definition
IVP push - check blood return before and after infusion
IV infusion - check blood return before and after infusion and q 2 during, only use CVL if unavailable MUST use a FRESH PIV
*LETHAL IF GIVEN INTRATHECALLY* |
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|
Term
| What are the possible side effects of Vincristine? |
|
Definition
| soft tissue damage with extravastion, neurotoxicity (peripheral neuropathy, decreased DTRs, jaw pain, constipation), no myelosuppression or N/V, SIADH |
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|
Term
| What is the nursing care for Viscristine? |
|
Definition
| Max dose 2mg, don't give more than once every 5 days |
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|
Term
| How is Cytoxan administered? |
|
Definition
|
|
Term
| What are the side effects of Cytoxan? |
|
Definition
| hemorrhagic cystitis, SIADH, metallic taste |
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|
Term
| What is the nursing care for Cytoxan? |
|
Definition
| check urine for blood prior to each dose, use uro-protectant MESNA when ordered, maintain good hydration IV hydration is essential following high doses, have pt void regularly for 24 hours following dose, monitor serum Na |
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|
Term
| How is Cis-Platinum administered? |
|
Definition
|
|
Term
| What are the possible side effects of Cis-Platinum? |
|
Definition
| nephrotoxicity, ototoxicity, electrolyte wasting, SIADH, severe N/V |
|
|
Term
| What is the nursing care for Cis-Platinum? |
|
Definition
| weigh at arrival and daily, strict I&O, monitor UOP, treat N/V prophylactically 30 mins prior to administration and q 4 prn |
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|
Term
| How is Methotrexate administered? |
|
Definition
|
|
Term
| What are the possible side effects of Methotrexate? |
|
Definition
| renal impairment, stomatitis/mucositis, rashes, leukoencephalopathy, hepatotoxicity, photosensitivity |
|
|
Term
| What is the nursing care for Methotrexate? |
|
Definition
| administer leucovorin as ordered, draw Methotrexate levels, Bactrim should be held during and following administration, maintain hydration (check urine specific gravity q8, maintain alkaline urine (check urine pH each void), oral care |
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|
Term
| How is Cytarabine administered? |
|
Definition
| IV push, IT, SQ, IV infusion |
|
|
Term
| What are the possible side effects of Cytarabine? |
|
Definition
| CNS toxicity, Ara-C Syndrome, fever, rash, conjunctivitis |
|
|
Term
| What is the nursing care with Cytarabine? |
|
Definition
| give steroid eye drops with high doses |
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|
Term
| How is Etoposide administered? |
|
Definition
| IV infusion over at least 2 hrs, PO |
|
|
Term
| What are the possible side effects of Etoposide? |
|
Definition
| anaphylaxis, hypotesion with rapid infusion |
|
|
Term
| What is the nursing care for Etoposide? |
|
Definition
| dilute to 0.4mg/mL, Epi 1:1000 IM at bedside, VS q 15mins for first hr then q 30 mins for 2nd hr, premedicate with Benadryl for each dose, stop and notify for uritcaria/cough, stop and give epi for severe wheezing/SOB and notify |
|
|
Term
| How is Prednisone administered? |
|
Definition
|
|
Term
| What are the possible side effects of Prednisone? |
|
Definition
| increased appetite/weight gain, HTN, heart burn, mood swings, transient diabetes, oral candidasis |
|
|
Term
| What is the nursing care for Prednisone? |
|
Definition
| monitor BP at least q shift, no added salt diet, disguise taste, monitor glucose, must be taken even if vomiting |
|
|
Term
| How is L-Asparaginase administered? |
|
Definition
|
|
Term
| What are the possible side effects of L-Asparaginase? |
|
Definition
| anaphylaxis, hypersensitivity reactions, transient diabetes, pancreatitis, no myelosuppression or N/V, coag abnormalities |
|
|
Term
| What is the nursing care for L-Asparaginase? |
|
Definition
| must have access to give meds/bolus in event of anaphylaxis, epi 1:1000 IM at beside, 0.01mg/kg to a max of 0.5mg, monitor for allergic reaction for 1-2 hrs after administering, give epi for anaphylaxis |
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|
Term
| How is Ifosfamide administered? |
|
Definition
|
|
Term
| What are the possible side effects of Ifosfamide? |
|
Definition
| hemorrhagic cystitis, renal tubular damage, CNS toxicity, SIADH, hyponatremia |
|
|
Term
| What is the nursing care for Ifosfamide? |
|
Definition
| check urine for blood before administering, always give MESNA with Ifosfamide, monitor serum Na, notify for any neuro changes |
|
|
Term
| How is Carboplatin administered? |
|
Definition
|
|
Term
| What are the possible side effects of Carboplatin? |
|
Definition
| myelosuppression esp thrombocytopenia, renal toxicity |
|
|
Term
| How is Topotecan administered? |
|
Definition
|
|
Term
| What are the possible side effects of Topotecan? |
|
Definition
| fever, flu-like symptoms, diarrhea |
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