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ONS ONCC Chemo Renewal/59 Complete Questions and Answers
ONS ONCC Chemo Renewal/59 Complete Questions and Answers
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ONS ONCC Chemo Renewal/59 CompleteQuestions and Answers
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:
-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
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