Chemotherapy

Subject: Medical and Surgical Nursing I (Theory)

Overview

Chemotherapy is the use of antineoplastic agents in an attempt to destroy tumor cells by interfering with cellular functions. It can be combined with surgery or radiation therapy or both to reduce tumor size pre-operatively, to destroy and remaining tumor cells post-operatively , or to treat some forms of leukemia. Common drugs used for it sre cysplastin, vincristine, 5-flourouracil, adriamycin, etc. Routes of chemotherapy: tropical, oral (pills or tablets ), Intravenous infusion, intramuscular, subcutaneous, etc. Chemotherapy is typically given in cycles, with rest periods between the cycles. A cycle can last 1, 2, 3, or 4 weeks. A typical course may consist of multiple cycles. Alopecia, Nausea and vomiting,-Mouth sores, etc are its side effects. Monitor hematocrit, platelets, total and differential leucocyte counts and also monitor BUN,ALT,AST, Bilirubin, uric acid and other necessary . Proper disposal of body fluid like saliva, urine , stool, vomits and blood to break down and get rid most of the drugs.

Chemotherapy

By interfering with biological processes, antineoplastic drugs are used in chemotherapy in an effort to kill tumor cells.

Systemic illnesses are often treated with chemotherapy as opposed to localized lesions that can be treated with surgery or radiation. It can be used in conjunction with radiation therapy, surgery, or both to treat some types of leukemia, eliminate any remaining tumor cells after surgery, or reduce the size of the tumor before surgery.

Common Chemotherapy Drugs:

  • Cyclophosphamide,
  • Cisplatin,
  • Vincristine,
  • 5-Flourouracil,
  • Adriamycin,
  • Methotrexate,
  • Leucovorin.

Routes of Chemotherapy:

  • Tropical,
  • Oral (pills or tablets ),
  • Intravenous infusion,
  • Intramuscular,
  • Subcutaneous.
  • Intrathecal and intraventricular

Dosage:

Dosage of antineoplastic agents is primarily based on the;

  • Patient total body surface area.
  • Previous response to chemotherapy or radiation therapy.
  • Major organ functions.

Chemotherapy Cycle:

  • Chemotherapy is typically given in cycles, with rest periods between the cycles. A cycle can last 1, 2, 3, or 4 weeks. A typical course may consist of multiple cycles.
  • Receiving some chemo drugs may take a relatively short period of time while others may take hours. It all depends on the treatment regimen that doctor prescribes.

Side Effects of Chemotherapy:

  • Bone marrow suppression; neutropenia, anemia.
  • Alopecia,
  • Nausea and vomiting,
  • Mouth sores,
  • Pain,
  • Peripheral neuropathy,
  • Forgetfulness and inability to concentrate,
  • Reproductive and sexual dysfunction.

Assessment of Client on Chemotherapy:

  • Perform a complete assessment before the therapy begins.

Assess the Hypersensitivity to the Drug.

  • Monitor vital signs and patency of catheter or IV line throughout the administration.
  • Monitor hematocrit, platelets, total and differential leucocyte counts and also monitor BUN, ALT, AST, Bilirubin, uric acid and other necessary.

Assess Client for Evidence of Infection:

  • Check vital signs every 4 hourly.
  • Carry out necessary investigation.
  • Insect all sites that may serve as port for pathogens ( IV sites, wounds, skin folds, perineum and oral cavity)

Client Teaching

  • Development of any of the following symptoms during cancer treatment may indicate a serious condition and should be reported to a physician.
    • Fever higher than 100.5*F,
    • Shaking chills,
    • Vomiting that continues 48 hours after treatment,
    • Bleeding of brushing,
    • Shortness of breath,
    • Painful or frequent urination,
    • Blood in urine or stool,
    • Dry cracked lips,
    • Increased pulse rate,
    • Mouth sores,
    • Dizziness,
    • Numbness or tingling in hands or feet.
    • Avoid contact with people who have known or recent infection or recent vaccination.
    • Proper disposal of body fluid like saliva, urine, stool, vomitus and blood to break down and get rid most of the drugs.
    • Use of barrier methods and delay in pregnancy should be done.
    • Keep the drugs away from the reach of children.
    • Flush the toilet after use.
    • Use of gloves by a caretaker to dispose of patients clothes, waste etc.

References

  • cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy.html
  • cancer.org/treatment/treatments-and-side-effects/treatment-types/chemotherapy/how-is-chemotherapy-used-to-treat-cancer.html
  • chemotherapy.com/new_to_chemo/what_is_chemo/
  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • webmd.com/cancer/questions-answers-chemotherapy
Things to remember
  • By interfering with biological processes, antineoplastic drugs are used in chemotherapy in an effort to kill tumor cells.
  • Chemotherapy is often administered in cycles with rest intervals in between. A cycle may last one, two, three, or four weeks.
  • Neutropenia, anemia, and bone marrow suppression are adverse effects.
  • Throughout administration, keep an eye on your vital signs and the integrity of your catheter or IV line.
  • Avoid making contact with those who have a recent or known infection or vaccination.
  • Caretakers dispose of patients' clothing, waste, etc. while wearing gloves.
Questions and Answers

By interfering with cellular processes, antineoplastic drugs are used in chemotherapy in an effort to kill tumor cells. Systemic illnesses are typically treated with chemotherapy as opposed to localized lesions that can be treated with surgery or radiation. It can be used in conjunction with radiation therapy, surgery, or both to treat some types of leukemia, eliminate any leftover tumor cells after surgery, and reduce tumor growth prior to surgery.

Common chemotherapy drugs:

  • Cyclophosphamide
  • Cysplastin
  • Vincristine
  • 5-flourouracil
  • Adriamycin
  • Methotrexate
  • Leucovorin

Nursing care for patient with chemotherapy:

  • Avoid making contact with anyone who have a recent or known infection or immunization.
  • Blood, urine, stool, vomit, and other bodily fluids should be properly disposed of in order to break down and remove the majority of pharmaceuticals.
  • Pregnancy should be delayed and barrier techniques used.
  • Keep the medications out of children's reach.
  • After using, flush the toilet.
  • Caretakers dispose of patients' clothing, garbage, etc. while wearing gloves.

Side effects of chemotherapy:

  • Neutropenia, anemia, and suppression of the bone marrow.
  • Alopecia
  • Vomiting and dizziness
  • Mouth ulcers
  • Pain
  • Neuropathy in the periphery
  • Forgetting things and a lack of focus
  • Sexual and reproductive dysfunction.

Assessment of client on chemotherapy:

  • Conduct a thorough assessment before therapy starts.
  • Analyze the medication sensitivities.
  • Throughout administration, keep an eye on your vital signs and the integrity of your catheter or IV line.
  • Hematocrit, platelets, total and differential leucocyte counts, as well as BUN, ALT, AST, Bilirubin, uric acid, and any other vital parameters, should all be monitored.

Assess client for evidence of infection:

  • Verify your vital signs every four hours.
  • Make the necessary research.
  • Insect any location that could be a pathogen entry point ( IV sites, wounds, skin folds, perineum and oral cavity)

Client teaching:

Development of any of the following symptoms during cancer treatment may indicate a serious condition and should be reported to a physician:

  • Higher than 100.5°F fever
  • Shivering fear
  • Repeated vomiting 48 hours after treatment
  • Brushing blood loss
  • Breathing difficulties
  • Excessive or painful urinating
  • Blood in the feces or urine
  • Chapped, dry lips
  • Raised heart rate
  • Mouth ulcers
  • Dizziness
  • Tingling or numbness in the hands or feet.

Avoid making contact with anyone who have a recent or known infection or immunization.

Blood, urine, stool, vomit, and other bodily fluids should be properly disposed of in order to break down and remove the majority of pharmaceuticals.

Pregnancy should be delayed and barrier techniques used.

Keep the medications out of children's reach.

After using, flush the toilet.

Caretakers dispose of patients' clothing, garbage, etc. while wearing gloves.

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