CHEMOTHERAPY STUDY GUIDE
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS 100%
CORRECT RATED A+ LATEST UPDATED
2025
Nadir -ANSWER✔✔the time when white blood cells and platelets are at the
lowest following chemo. Typically happens 7-14 days post chemo, with recovery
by 21-28 days
Tumor lysis syndrome -ANSWER✔✔Syndrome that occurs after chemo has been
given. Occurs when the chemo causes rapid destruction of large amounts of tumor
cells. Causes hyperuricemia which can lead to renal failure. Also causes
hyperkalemia, hyperphosphatemia, and hypocalcemia
Vesicant -ANSWER✔✔types of drugs that can cause blisters and tissue necrosis.
Irritant -ANSWER✔✔drugs that cause burning in the IV
Tumor burden -ANSWER✔✔the total amount of tumor in the patient's body
Neo-adjuvant treatment -ANSWER✔✔Chemotherapy given prior to primary
treatment, such as surgery. Goal is to shrink the tumor prior to removal and/or to
reduce the chance of micrometastatis
Palliative treatment -ANSWER✔✔given to help relieve symptoms of cancer and
improve quality of life
,Adjuvant treatment -ANSWER✔✔additional cancer treatment that is given after
the primary curative treatment (surgery). Goal is to eradicate the residual disease,
reduce recurrence rates, and reduce death rates.
AUC dosing -ANSWER✔✔Area under the curve. Accounts for age, gender,
weight, and renal function
Routes of chemotherapy administration -ANSWER✔✔oral, intravenous,
subcutaneous, intramuscular, intraperitoneal, intrathecal, intrapleural,
intravesicular, intraarterial, and HIPEC
What drugs can be given intrathecally? -ANSWER✔✔Methotrexate and
cytarabine
What are the two ways that intrathecal chemotherapy can be administered? -
ANSWER✔✔Through an onmaya or through a lumbar puncture
What is the rationale for the use of intrathecal chemotherapy? -ANSWER✔✔It
goes directly into the central nervous system when there is CNS involvement with
leukemia or lymphoma
What are common side effects/complications of intrathecal chemotherapy? -
ANSWER✔✔Headache, changes in neuro status, new confusion
Please define acute, delayed, and anticipatory nausea/vomiting and describe the
treatment for each. -ANSWER✔✔Acute: occurs during the 1st 18-24 hours after
chemo. Treatment includes zofran, fosfaprepitent, and dexamethasone.
Delayed: begins greater than 24 hours after chemo. Treatment includes
fosfaprepitent, dexamethasone, and sometimes olanzapine.
, Anticipatory: Begins prior to chemo.
Treatment includes zofran and lorazepam.
Please discuss discharge instructions for nausea/vomiting management following
chemotherapy. -ANSWER✔✔Eating cold foods and drinks can be better to have
rather than warm or hot foods which can make you more nauseous. Zofran can be
taken 30 min prior to eating to help prevent nausea and vomiting.
Why is leucovorin administered with 5FU? -ANSWER✔✔To increase the
cytotoxic effects of 5FU
What test should be done prior to starting treatment with anthracyclines (ex.
idarubicin, adriamycin)? -ANSWER✔✔ECHO to know the ejection fraction
How is cardiotoxicity monitored? And what signs and symptoms would you watch
for? -ANSWER✔✔The physician gets a baseline EF prior to starting treatment and
then they keeps track of lifetime cumulative doses. In acute toxicity you may see
ECG changes and arrhythmias, in chronic it can manifest from symptomatic
decline in EF to irreversible CHF.
Please discuss the procedure for treating an extravasation, including where the
orders are located. What specific treatment is used for an adriamycin extravasation.
-ANSWER✔✔Stop the infusion, leave the iv in place and attempt to aspirate any
residual drug. Then remove the IV. For Adriamycin, give 1000mg/m2 of totect in
1000 ml NS over 1-2 hours. Give the infusion in another/new IV site. Apply an ice
pack 15 minutes prior to infusion of totect. Elevate extremity if patient is able.
Notify physician and take pictures of the extravasation site and place in the chart.
Assess the site frequently for pain, blisters, and skin sloughing. Totect gets
administered on days 2 and 3
QUESTIONS AND ANSWERS WITH
COMPLETE SOLUTIONS 100%
CORRECT RATED A+ LATEST UPDATED
2025
Nadir -ANSWER✔✔the time when white blood cells and platelets are at the
lowest following chemo. Typically happens 7-14 days post chemo, with recovery
by 21-28 days
Tumor lysis syndrome -ANSWER✔✔Syndrome that occurs after chemo has been
given. Occurs when the chemo causes rapid destruction of large amounts of tumor
cells. Causes hyperuricemia which can lead to renal failure. Also causes
hyperkalemia, hyperphosphatemia, and hypocalcemia
Vesicant -ANSWER✔✔types of drugs that can cause blisters and tissue necrosis.
Irritant -ANSWER✔✔drugs that cause burning in the IV
Tumor burden -ANSWER✔✔the total amount of tumor in the patient's body
Neo-adjuvant treatment -ANSWER✔✔Chemotherapy given prior to primary
treatment, such as surgery. Goal is to shrink the tumor prior to removal and/or to
reduce the chance of micrometastatis
Palliative treatment -ANSWER✔✔given to help relieve symptoms of cancer and
improve quality of life
,Adjuvant treatment -ANSWER✔✔additional cancer treatment that is given after
the primary curative treatment (surgery). Goal is to eradicate the residual disease,
reduce recurrence rates, and reduce death rates.
AUC dosing -ANSWER✔✔Area under the curve. Accounts for age, gender,
weight, and renal function
Routes of chemotherapy administration -ANSWER✔✔oral, intravenous,
subcutaneous, intramuscular, intraperitoneal, intrathecal, intrapleural,
intravesicular, intraarterial, and HIPEC
What drugs can be given intrathecally? -ANSWER✔✔Methotrexate and
cytarabine
What are the two ways that intrathecal chemotherapy can be administered? -
ANSWER✔✔Through an onmaya or through a lumbar puncture
What is the rationale for the use of intrathecal chemotherapy? -ANSWER✔✔It
goes directly into the central nervous system when there is CNS involvement with
leukemia or lymphoma
What are common side effects/complications of intrathecal chemotherapy? -
ANSWER✔✔Headache, changes in neuro status, new confusion
Please define acute, delayed, and anticipatory nausea/vomiting and describe the
treatment for each. -ANSWER✔✔Acute: occurs during the 1st 18-24 hours after
chemo. Treatment includes zofran, fosfaprepitent, and dexamethasone.
Delayed: begins greater than 24 hours after chemo. Treatment includes
fosfaprepitent, dexamethasone, and sometimes olanzapine.
, Anticipatory: Begins prior to chemo.
Treatment includes zofran and lorazepam.
Please discuss discharge instructions for nausea/vomiting management following
chemotherapy. -ANSWER✔✔Eating cold foods and drinks can be better to have
rather than warm or hot foods which can make you more nauseous. Zofran can be
taken 30 min prior to eating to help prevent nausea and vomiting.
Why is leucovorin administered with 5FU? -ANSWER✔✔To increase the
cytotoxic effects of 5FU
What test should be done prior to starting treatment with anthracyclines (ex.
idarubicin, adriamycin)? -ANSWER✔✔ECHO to know the ejection fraction
How is cardiotoxicity monitored? And what signs and symptoms would you watch
for? -ANSWER✔✔The physician gets a baseline EF prior to starting treatment and
then they keeps track of lifetime cumulative doses. In acute toxicity you may see
ECG changes and arrhythmias, in chronic it can manifest from symptomatic
decline in EF to irreversible CHF.
Please discuss the procedure for treating an extravasation, including where the
orders are located. What specific treatment is used for an adriamycin extravasation.
-ANSWER✔✔Stop the infusion, leave the iv in place and attempt to aspirate any
residual drug. Then remove the IV. For Adriamycin, give 1000mg/m2 of totect in
1000 ml NS over 1-2 hours. Give the infusion in another/new IV site. Apply an ice
pack 15 minutes prior to infusion of totect. Elevate extremity if patient is able.
Notify physician and take pictures of the extravasation site and place in the chart.
Assess the site frequently for pain, blisters, and skin sloughing. Totect gets
administered on days 2 and 3
