QUESTIONS AND ANSWERS SURE A+
✔✔8.4% - ✔✔It is important that the nurse recognizes certain drugs that, when given
together, may result in a higher risk of adverse events. For example, in neoadjuvant
clinical trials using trastuzumab and pertuzumab, the incidence of decline in left
ventricular ejection fraction (LVEF) was 1.9% in patients treated with trastuzumab and
docetaxel, compared to ______ of those treated with trastuzumab, docetaxel, and
pertuzumab (Genentech, 2013).
✔✔Consider the potential toxicity related to each drug.
Understand the monitoring guidelines for each drug.
Have knowledge of clinically significant signs and symptoms. - ✔✔Key Points for
Combination Therapy
✔✔Improved patient outcomes.
Increased nurse satisfaction.
Potential cost savings. - ✔✔Evidence-based practice can have positive effects, such as:
✔✔Smoking
Increased age
Alcohol intake
History of Polyps - ✔✔Risk factors for colon cancer
✔✔50 - ✔✔The chance of developing colorectal cancer increases markedly after age
_____. Roughly 9 out of 10 people diagnosed with colorectal cancer are at least ____
years old.
✔✔Racial and ethnic backgrounds (African Americans and Jews of Eastern European
descent (Ashkenazi Jews) have highest incidence)
Diet high in red and processed meats
Physical inactivity, obesity
Type 2 diabetes
, Family history of colon cancer or inflammatory bowel disease
Inherited familial syndromes (FAP, HNPCC) - ✔✔Other risk factors for the development
of colorectal cancer include:
✔✔FOLFOX6
Oxaliplatin 100mg/m2 and Leucovorin 400 mg/m2 IV over 2-hours, then
5-fluorouracil (5-FU) 400 mg/m2 IV bolus, followed by
5-FU 3,000 mg/m2 IV by continuous infusion over 46 hours - ✔✔Treatment regiment for
Colorectal Cancer
✔✔Cold sensory neuropathy - ✔✔Which of the following is a unique side effect that
occurs with the agent oxaliplatin?
✔✔Transient paresthesia
Dysesthesia and hypoesthesia in the hands, feet, perioral area, or throat.
Jaw spasm
Abnormal tongue sensation
Dysarthria
Eye pain, and a feeling of chest pressure have also been observed - ✔✔Cold sensory
neuropathy symptoms
✔✔Duloxetine
Gabapentin and Opioid Combination - ✔✔Effective treatments for peripheral neuropathy
✔✔Per the ONS PEP resources for mucositis (https://www.ons.org/practice-
resources/pep/mucositis), of the listed answers, oral care protocol would be what the
nurse needs to ensure Mr. Patterson is doing at home for his early mucositis to prevent
it from worsening. - ✔✔Thinking that this is early mucositis, which of the following
should the nurse instruct Mr. Patterson to do to help his symptoms?
✔✔Risk factors for mucositis that are not from the agents themselves include the
following: dental disease and poor oral hygiene, ill-fitting dentures, advanced age and
youth age, history of alcohol and tobacco use, poor nutrition, intake of irritating foods
(spicy or acidic foods), and dehydration (Information from the chemo/bio guidelines
page 214-215). Mr. P. has both a poor diet and also uses tobacco (both chewing
tobacco and cigarettes) and alcohol. The use of tobacco products is a big risk factor for
development of mucositis. - ✔✔Which of the following of Mr. Patterson's lifestyle factors
put him at the most risk for developing mucositis?
✔✔Recommended for Practice:
Cryotherapy
Low Level Laser Therapy in Patients Undergoing Hematopoietic Cell Transplantation
Low Level Laser Therapy in Patients With Head and Neck Cancer