Fundamentals of Chemotherapy Immunotherapy Administration questions and answers 2024

Key Points for Combination Therapy Oncology Nurses must consider Consider the potential toxicity related to each drug. Understand the monitoring guidelines for each drug. Have knowledge of clinically significant signs and symptoms ONS Evidence-Based Practice Resources Evidence-based practice can have positive effects, such as: Improved patient outcomes Increased nurse satisfaction Potential cost savings Risk Factors For Colon Cancer Increased age is a risk factor for developing colorectal cancer. The chance of developing colorectal cancer increases markedly after age 50. Roughly 9 out of 10 people diagnosed with colorectal cancer are at least 50 years old. Smoking, alcohol intake, and a personal history of polyps are all things that increase risk. Other risk factors for the development of colorectal cancer include: 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) Patient Education on Chemotherapy Patients are provided with verbal and written or electronic information as part of an education process before the first administration of treatment of each treatment plan. The content of this educational material will be documented. Educational information includes the following at a minimum: Patient's diagnosis Goals of treatment; that is, cure disease, prolong life, or reduce symptoms Planned duration of treatment, schedule of treatment administration, drug names and supportive medications, drug-drug and drug-food interactions, and plan for missed doses Potential long-term and short-term adverse effects of therapy, including infertility risks for appropriate patients Symptoms or adverse effects that require the patient to contact the healthcare setting or to seek immediate attention Symptoms or events that require immediate discontinuation of oral or other self-administered treatments Procedures for handling medications in the home, including storage, safe handling, and management of unused medication Procedures for handling body secretions and waste in the home Follow-up plans, including laboratory and provider visits Contact information for the healthcare setting, with availability and instructions on when and who to call The missed appointment policy of the healthcare setting and expectations for rescheduling or cancelling Education includes family, caregivers, or others based on the patient's ability to assume responsibility for managing therapy. Educational activities will be performed based on the patient's learning needs, abilities, preferences, and readiness to learn. Folfox 6 he treatment regimen, FOLFOX6, consists of chemotherapy in two-week cycles over a six-month period. Ensuring patient understanding of the treatment and anticipated side effects before initiation of therapy is an important safety standard and should be documented in the patient record (Neuss et al., 2016). Mr. Patterson is also provided written information regarding his chemotherapy regimen to review at home. Mr. Patterson's treatment plan with FOLFOX6 consists of the following: Oxaliplatin 100 mg/m2 and Leucovorin 400 mg/m2 IV over two 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 You have a long discussion with Mr. Patterson about his chemotherapy regimen, including his need for a port placement for IV access since he will be receiving 5-FU by continuous infusion for 46 hours. You discuss each agent in detail with Mr. Patterson, including the potential side effects of the agents he will receive. Your teaching highlights self-management strategies for these toxicities as well as when and how to reach someone from the office at any time of day. Which of the following is a unique side effect that occurs with the agent oxaliplatin? . Cold sensory neuropathy Cold Sensory Neuropathy Per the prescribing information for oxaliplatin, "the cold sensory neuropathy is an acute, reversible, primarily peripheral, sensory neuropathy of early onset (occurring within hours or one to two days of dosing) which resolves within 14 days, but frequently recurs with further dosing." The symptoms may be precipitated or exacerbated by exposure to cold temperature or cold objects. They usually present as 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. Exposure to cold can cause very painful sensations following oxaliplatin therapy. Mr. Patterson is encouraged to avoid cold temperatures during the days following chemotherapy. Resolution of this side effect usually occurs within five days following therapy, but may last longer (Sanofi-Aventis, 2014). peripheral neuropathy disorder of the peripheral nerves that carry information to and from the brain and spinal cord folfox 6 side effects You discuss many other side effects of the agents (oxaliplatin, leucovorin, and 5-FU) that Mr. Patterson will receive. You cover the following common side effects of this chemotherapy regimen: peripheral neuropathy, myelosuppression, N/V/D, fatigue, fever, mucositis, alopecia, anorexia, and photosensitivity. You provide Mr. Patterson written handouts that review this same information. ONS PEP resources include evidence-based information on some of these side effects: Peripheral Neuropathy Prevention of Infection CINV Diarrhea Fatigue Mucositis