https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal
50 - ANS-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.
65 - ANS-The NCCN Older Adult Oncology Guidelines (version 1.2015) provides information on
what is included in a comprehensive geriatric assessment. Currently, more than 60% of cancers
in the United States occur in people age ______and older and as the oncology world ages,
nearly half (46%) of cancer survivors are 70 years of age or older
8.4% - ANS-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).
85% - ANS-Amgen (2007) defines RDI as "is a quantification of how closely an administered
course of chemotherapy treatment adheres to a specific regimen." Three separate clinical trials
evaluating outcomes in patients with breast cancer related to RDI have demonstrated improved
overall survival and 10-year disease free survival in patients who receive a RDI > or =
____?_____
A comprehensive geriatric assessment (CGA) is a multidisciplinary evaluation to assess life
expectancy and risk of morbidity and mortality in the older patient. This assessment tool would
evaluate and include the following areas: functional status, socioeconomic issues, psychosocial
distress, comorbidities, cognitive function, nutritional status, polypharmacy, and a medication
review (NCCN Older Adult Oncology Guidelines, version 1.2015). - ANS-Due to Mrs. Turner's
age and comorbidities, her oncologist performs a comprehensive geriatric assessment. You
know that this assessment covers all but which of the following:
A dose-limiting toxicity of cyclophosphamide is hemorrhagic cystitis. Although it is more
commonly seen with high-dose therapy, it can still occur in patients receiving R-CHOP. -
ANS-Which of the agents that Mr. Rylan is receiving in R-CHOP would be the likely culprit if this
is hemorrhagic cystitis?
a. Stop the paclitaxel infusion - ANS-Mrs. Kearns is receiving her first dose of paclitaxel and
about 20 minutes into the infusion, you notice that she begins to start clearing her throat a lot.
She also states that she is having some lower back pain. You decide that you will take another
set of vital signs. While you are waiting for the monitor to reveal her blood pressure, she begins
to breathe heavier and appears short of breath.
What is the first/immediate thing you need to do for Mrs. Kearns?
https://www.stuvia.com/user/allatopnotch https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
, https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
https://www.stuvia.com/user/allatopnotch
Administering HDs by any route (PO, IV, IT, etc.)
Handling any HD vials, ampules, or packaging materials
Introducing or withdrawing needles or dispensing pins from HD vials
Transferring drugs from HD vials to other containers using needles, dispensing pins, or syringes
Opening ampules or HDs
Expelling air from an HD-filled syringe
Spiking IV bags containing HDs and changing IV tubing
Priming IV tubing with HDs
Handling HD leakage from tubing, syringe, and connection sites
Discontinuing infusions of HDs
Disposing of HDs and items contaminated by HDs
Handling the body fluids of a patient who had received HDs in the past 48 hours
Cleaning HD spills
Touching any surface that is potentially contaminated with HD residue - ANS-PPE should be
worn whenever there is a potential that hazardous drugs could be released into the environment
like in the following situations:
Although all the other answers listed can happen with rituximab, you are most concerned about
the potential for a hypersensitivity reaction since this is rituximab and it is the patient's first dose.
- ANS-What is the most important toxicity that you will monitor for with rituximab especially since
this is the patient's first dose of the agent?
Although hypersensitivity and infusion reactions can occur at any time and potentially with any
chemotherapy agent, there are certain agents that have a higher risk of causing a reaction. For
some agents, the reaction is more likely to occur after they have received a few doses and have
already been exposed to the same agent. On the other hand, there are agents where the
hypersensitivity reactions can occur almost immediately on exposure. Reactions to platinum
drugs (e.g., carboplatin, cisplatin, oxaliplatin) usually occur after multiple treatments. However,
reactions caused by taxanes (e.g., paclitaxel, docetaxel) usually occur within the first hour of the
first or second treatment. Reactions to monoclonal antibodies like rituximab and cetuximab
usually occur with the first treatment as well. (Information from Zetka article) - ANS-Which of the
following agents would you anticipate a hypersensitivity reaction more often occurring after the
patient has already received several doses?
Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbine - ANS-DNA Nonbinding vessicants
ANC = (Neutrophils + Bands) x WBC / 100
https://www.stuvia.com/user/allatopnotch https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal
50 - ANS-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.
65 - ANS-The NCCN Older Adult Oncology Guidelines (version 1.2015) provides information on
what is included in a comprehensive geriatric assessment. Currently, more than 60% of cancers
in the United States occur in people age ______and older and as the oncology world ages,
nearly half (46%) of cancer survivors are 70 years of age or older
8.4% - ANS-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).
85% - ANS-Amgen (2007) defines RDI as "is a quantification of how closely an administered
course of chemotherapy treatment adheres to a specific regimen." Three separate clinical trials
evaluating outcomes in patients with breast cancer related to RDI have demonstrated improved
overall survival and 10-year disease free survival in patients who receive a RDI > or =
____?_____
A comprehensive geriatric assessment (CGA) is a multidisciplinary evaluation to assess life
expectancy and risk of morbidity and mortality in the older patient. This assessment tool would
evaluate and include the following areas: functional status, socioeconomic issues, psychosocial
distress, comorbidities, cognitive function, nutritional status, polypharmacy, and a medication
review (NCCN Older Adult Oncology Guidelines, version 1.2015). - ANS-Due to Mrs. Turner's
age and comorbidities, her oncologist performs a comprehensive geriatric assessment. You
know that this assessment covers all but which of the following:
A dose-limiting toxicity of cyclophosphamide is hemorrhagic cystitis. Although it is more
commonly seen with high-dose therapy, it can still occur in patients receiving R-CHOP. -
ANS-Which of the agents that Mr. Rylan is receiving in R-CHOP would be the likely culprit if this
is hemorrhagic cystitis?
a. Stop the paclitaxel infusion - ANS-Mrs. Kearns is receiving her first dose of paclitaxel and
about 20 minutes into the infusion, you notice that she begins to start clearing her throat a lot.
She also states that she is having some lower back pain. You decide that you will take another
set of vital signs. While you are waiting for the monitor to reveal her blood pressure, she begins
to breathe heavier and appears short of breath.
What is the first/immediate thing you need to do for Mrs. Kearns?
https://www.stuvia.com/user/allatopnotch https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
, https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
https://www.stuvia.com/user/allatopnotch
Administering HDs by any route (PO, IV, IT, etc.)
Handling any HD vials, ampules, or packaging materials
Introducing or withdrawing needles or dispensing pins from HD vials
Transferring drugs from HD vials to other containers using needles, dispensing pins, or syringes
Opening ampules or HDs
Expelling air from an HD-filled syringe
Spiking IV bags containing HDs and changing IV tubing
Priming IV tubing with HDs
Handling HD leakage from tubing, syringe, and connection sites
Discontinuing infusions of HDs
Disposing of HDs and items contaminated by HDs
Handling the body fluids of a patient who had received HDs in the past 48 hours
Cleaning HD spills
Touching any surface that is potentially contaminated with HD residue - ANS-PPE should be
worn whenever there is a potential that hazardous drugs could be released into the environment
like in the following situations:
Although all the other answers listed can happen with rituximab, you are most concerned about
the potential for a hypersensitivity reaction since this is rituximab and it is the patient's first dose.
- ANS-What is the most important toxicity that you will monitor for with rituximab especially since
this is the patient's first dose of the agent?
Although hypersensitivity and infusion reactions can occur at any time and potentially with any
chemotherapy agent, there are certain agents that have a higher risk of causing a reaction. For
some agents, the reaction is more likely to occur after they have received a few doses and have
already been exposed to the same agent. On the other hand, there are agents where the
hypersensitivity reactions can occur almost immediately on exposure. Reactions to platinum
drugs (e.g., carboplatin, cisplatin, oxaliplatin) usually occur after multiple treatments. However,
reactions caused by taxanes (e.g., paclitaxel, docetaxel) usually occur within the first hour of the
first or second treatment. Reactions to monoclonal antibodies like rituximab and cetuximab
usually occur with the first treatment as well. (Information from Zetka article) - ANS-Which of the
following agents would you anticipate a hypersensitivity reaction more often occurring after the
patient has already received several doses?
Amsacrine
Paclitaxel
Vinblastine
Vincristine
Vindesine
Vinorelbine - ANS-DNA Nonbinding vessicants
ANC = (Neutrophils + Bands) x WBC / 100
https://www.stuvia.com/user/allatopnotch https://www.stuvia.com/user/allatopnotch
ONS ONCC Chemo Renewal.pdfhttps://www.stuvia.com/user/allatopnotch
