Question

The oncology clinical nurse specialist (CNS) is asked to develop a staff development program for registered nurse who will be administering chemotherapeutic agent. Because the nurses will be administering a variety of chemotherapeutic drugs to oncology patients, the CNS plans on presenting an overview of agents,classifications, and special precaution of these drugs.( Learning objective 6 and 8).
a. What does the CNS describe as the goals of chemotherapy?
b. How should the CNS respond to the following equation:" why do patients require rounds of chemotherapeutic drugs, including different drugs and varying intervals?"
c.In teaching about the administration of chemotherapeutic agents.what signs of extravasation should the nurse include?
d. what clinical manifestations of myelosupprssion secondary to chemotherapy administration, should the CNS include in this program?

Answer 1

a. There are three major goals of chemotherapy- 1) Cure the cancer if possible i.e. eliminate cancer cells until they are no longer detected in your body. 2) Control the cancer from spreading by destroying or slowing the growth of cancer cells. 3) Ease the symptoms of cancer in patients suffering from advanced stage of cancer.

b. Cancer patients are given different types and combination of chemo drugs based on the type and stage of cancer. Chemo is given in a series of treatment periods known as chemo-cycles. During a cycle chemo is given several times in pre-decided intervals. The interval between two chemo treatments helps the patient to recover from side effects of chemo drugs and produce new healthy cells.

c. Extravasation during administration chemotherapeutic agents is suspected if one or more of the following signs is observed during or immediately after the injection-

1) If patient complains of burning or pain at the injection site. 2) If induration, swelling or leakage is observed at the injection site. 3) If there is obstruction in free flow of injection. 4) If flare reactions or venous spasm is observed. 5) If resistance is felt on syringe plunger during administration.

d. Myelosuppression, also known as bone marrow suppression, is a common side effect of chemotherapy that is characterized by a decrease in blood cell production. Clinical manifestations of myelosupprssion secondary to chemotherapy administration include- 1) A decrease in red blood cells, this type of myelosupprssion is called anemia. 2) A drop in a specific type of white blood cells known as neutrophils, this type of myelosupprssion is called neutropenia. 3) A drop in platelet count, this type of myelosupprssion is called thrombocytopenia.

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