ONS/ONCC Chemotherapy/Immunotherapy Lesson 14: Administration of Drugs practice test with verified accurate expert solutions(2024 LATEST UPDATE)ALREADY GRADED A+(GUARANTEED SUCCESS)

Verification of Treatment as Planned -vascular access device appropriate for treatment plan -will patient adhere to plan -is the treatment plan appropriate for patient -do additional referals need to be made for treatment -is there evidenced based rationale for treatment -is the drug a vesicant and are there safety precautions in place -is the drug a cumulative lifetime dose limit and is there tracking in place Patient education -assess pt's readiness to learn, health literacy, preferred method of learning, barriers to learning -provide pt with info needed in the way that they need to be as informed about treatment plan as possible -verify pts/any caregivers or significant others can verbalize understanding of info Considerations when scrutinizing the treatment plan -right tx plan for disease, pt, and stage -goal of tx stated -drugs, frequence, dose stated -appropriate premeds -appropriate hydration -pt venous access options -to avoid delays/maintain dose intensity, what potential side effects should be anticipated & how can these be proactively addressed -dose-density of therapy/does it apply -is dose intensity appropriate Recommendations to Prevent Errors -nurse administrating meds needs to verify labs, vs, ht, wt from that day -2 ONC cert RN need to check parameters independently -use of smart pumps -unchaotic environment Vascular Access options for Administering -PIV -Midline cath -nontunneled central cath -temporary apheresis/hemodialysis cath -tunneled apheresis/hemodialysis cath -PICC -Implanted venous cath -tunneled venous cath IV Site Selection 1. Use distal veins of the upper extremities first. 2. Subsequent venipuncture should be proximal to or higher than the previous site. 3. Select veins above or below an area of flexion. 4. Try to select a site on the client's nondominant extremity. 5. Select a vein large enough to accommodate the catheter. IV sites to avoid. 1. Areas of flexion, especially the antecubital area. (NO CHEMO TO ANTECUBITAL) 2. Veins previously injured by infiltration or phlebitis. 3. Veins of an affected extremity: mastectomy, dialysis access. 4. Veins of an extremity affected by stroke or neurologic trauma. 5. Veins in the lower extremities and sclerosed or irritated veins. 6. Avoid previous venipuncture sites, areas of inflammation or bruising. Specific Infusion Guidelines for vesicants 1. stay with the patient throughout infusion 2. vesicant infusions through PIV should be no longer than 30-60min 3. verify blood return frequently Weight Based Dosage -dose based on body weight -usually kg -current wt on day of drug delivery crucial for accurate dose Body Surface Area (BSA) dosage -applies to most IV infused chemo and immunotherapy drugs -m2 BSA calculation sqrt[cm*kg / 3600 ] Area under the curve (AUC) Dosage -used for carboplatin -AUC is the amount of drug concentration in the blood over a period of time -renal function is part of calculation because carboplatin drug clearance is associated with renal function