Antineoplasics (12)

Question 1

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TAMOXIFEN: Nursing Considerations

Answer 1

• Peak 4–7 hours
• To decrease GI upset, take after antacid, after evening meal, before bedtime, or take antiemetic 30–60 minutes ahead
• Vaginal bleeding, pruritus, hot flashes are reversible after stopping med
• Contact provider if decreased visual acuity, which may be irreversible
• Tumor flare (increase in tumor size and increased bone pain) may occur, but will decrease rapidly; may take analgesics for pain
• Rx; Preg Cat D

Question 2

TAMOXIFEN: Side Effects

Answer 2

• Nausea, vomiting
• Hot flashes, headache
• Rash
• Vaginal discharge
• Vision abnormalities
• Irregular menses
• Fluid retention
• Depression, mood disturbances
• Chest pain

Question 3

TAMOXIFEN: Purpose

Answer 3

Management of advanced breast cancer not responsive to other therapy in estrogen-receptor-positive patients

Question 4

METHOTREXATE: Nursing Considerations

Answer 4

• PO, IM, IV: onset 4–7 days, peak 7–14 days, duration 21 days
• Avoid crowds and people with known infections
• Do not take with ASA or other NSAIDs, which may cause GI bleeding
• Monitor for pulmonary toxicity, which may manifest early as a dry, nonproductive cough
• Do not take with proton pump inhibitors
• Increase fluid intake to 10–12 glasses/day
• Rx; Preg Cat X

Question 5

METHOTREXATE: Side Effects

Answer 5

• Nausea, vomiting, diarrhea
• Anorexia
• Alopecia, rash
• Ulcerative stomatitis
• Dizziness, headache
• Renal abnormalities
• Hepatotoxicity
• Thrombocytopenia

Question 6

METHOTREXATE: Purpose

Answer 6

Treatment of cancer, psoriasis, rheumatoid arthritis, and mycosis fungoides

Question 7

CYCLOPHOSPHAMIDE: Nursing Considerations

Answer 7

• Use cytotoxic handling procedures
• Avoid evening dosing
• Give antiemetic 30–60 minutes before treatment
• PO: take on an empty stomach
• Monitor temperature every 4 hours
• Increase fluid intake to 2–3 L/day
• Rinse mouth 3–4 times/day for stomatitis
• Avoid aspirin, ibuprofen
• Avoid vaccinations during therapy
• Rx

Question 8

CYCLOPHOSPHAMIDE: Side Effects

Answer 8

• Headache, dizziness
• Cardiotoxicity
• SIADH
• Stomatitis
• Nausea, vomiting
• Hepatotoxicity
• Hemorrhagic crisis
• Renal tubular necrosis
• Sterility
• Leukopenia
• Alopecia
• Hyperuricemia
• Pulmonary fibrosis

Question 9

CYCLOPHOSPHAMIDE: Purpose

Answer 9

Treatment of cancer

Question 10

CISPLATIN: Nursing Considerations

Answer 10

• Use cytotoxic handling procedures
• Give antiemetic 30–60 minutes before treatment
• Monitor temperature every 4 hours
• Increase fluid intake to 2–3 L/day
• Rinse mouth 3–4 times/day for stomatitis
• Avoid vaccinations during therapy
• Rx

Question 11

CISPLATIN: Side Effects

Answer 11

• Seizures
• Peripheral neuropathy
• Cardiac abnormalities
• Ototoxicity
• Blurred vision
• Stomatitis
• Nausea, vomiting
• Renal tubular damage
• Thrombocytopenia, leukopenia
• Sterility
• Alopecia
• Hypomagnesemia
• Hypocalcemia
• Hypokalemia
• Hypophosphatemia
• Fibrosis

Question 12

CISPLATIN: Purpose

Answer 12

Treatment of advanced bladder cancer, adjunct therapy in metastatic testicular and ovarian cancer