ONS ONCC Chemo Renewal(Solved)2022

Neoadjuvant therapy does not increase survival when compared to adjuvant therapy. It only changes the timing of treatment and can change surgical options if the tumor is shrunk enough. If this occurs, the patient may only require a lumpectomy plus radiation therapy instead of needing a mastectomy Main benefit of neoadjuvant chemotherapy (breast cancer patient) 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). 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: 00:02 01:17 65 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 Two of the agents (docetaxel and carboplatin) that Mrs. Turner will receive are categorized as irritants. Docetaxel can cause a significant reaction if it extravasates. It can lead to edema, erythema, occasional pain and blister formation (ONS Chemo/Bio guidelines, 2014). That is the most likely reason that Mrs. Turner was given a port for her treatments. Some patients will receive their treatments through a peripheral IV without incident. Just because they are intravenous agents does not mean that a port is required and needing a port has nothing to do with her being older in age. Since none of these agents are vesicants, they likely could have been given safely via peripheral route but having a port placed is OK as well. What is your best explanation for why Mrs. Turner was given a port to receive her chemotherapy? Irrirtants _____________can cause inflammation, pain, and burning but rarely cause tissue necrosis comparable to a vesicant (unless a large amount or a very high concentration of the irritant is extravasated). Vesicants _____________can cause blistering and significant pain and tissue damage and destruction, leading to tissue death. Non-DNA-binding solutions remain in the local area of the extravasation, which improves the possibility of drug deactivation. DNA-binding agents attach to DNA nucleic acids, causing the antagonist to be ingested cellularly, leading to progressive tissue destruction A further classification of an antineoplastic agent's potential to cause damage is whether its mechanism of action includes DNA binding. Bendamustinea Dactinomycin Daunorubicin Doxorubicin Epirubicin Idarubicin Mechlorethamine Mitomycin DNA Binding Irritants Amsacrine Paclitaxel Vinblastine Vincristine Vindesine Vinorelbine DNA Nonbinding vessicants Sodium thiosulfate Inject 2 ml of sodium thiosulfate for each milligram of mechlorethamine extravasated. Inject subcutaneously into extravasation site using a 25 gauge or smaller needle (change needle with each injection). Monitor extravasation site according to the institution's policies and procedures. Extravasciation Alkylating / Mechlorethamine tx Apply warm compresses. Dexamethasone 8 mg twice daily for 14 days Extravasciation Alkylating: Oxaliplatin Totect Apply ice pack (remove 15 minutes prior to Totect treatment). Infusion should be initiated within six hours of extravasation. Infused over 1-2 hours for three days in an area other than the extravasation site The dose recommended is based on the patients' body surface area. • Day 1: 1,000 mg/m2 • Day 2: 1,000 mg/m2 • Day 3: 500 mg/m Extravasation Tx: Anthracyclines --- Daunorubicin, doxorubicin, epirubicin, idarubicin 00:05 01:17