What is a central catheter used in cancer patients? - For chemotherapy administration
or laboratory blood testing
Why is a central catheter used in cancer patients? - Some medications can cause
serious damage to the skin and muscle tissue if they leak outside a vein (vesicants). Getting
these t...
ATI CBC 3 Review Questions with
Correct Answers
What is a central catheter used in cancer patients? - ✔For chemotherapy administration
or laboratory blood testing
Why is a central catheter used in cancer patients? - ✔Some medications can cause
serious damage to the skin and muscle tissue if they leak outside a vein (vesicants). Getting
these through a central venous catheter instead of a short-term IV reduces the risk that the
medication will leak and damage tissues.
Many different types can be used.
Common types of central catheters used in cancer patients - ✔Peripherally inserted
central catheter
Implanted port
Implanted port - ✔Used when therapy is intended to be given on a long-term basis
Comprised of a small reservoir that is covered by a thick septum
Categories of chemo medications - ✔Alkylating agents, antimetabolites, anti mitotic
agents, antitumor antibiotics, Topoisomerase inhibitors, and other miscellaneous
medications
How are medication categories chosen for cancer? - ✔Based on the sensitivity of cancer
cells to the medications and the stage of the cancer
Nursing considerations for chemotherapy - ✔Instruct the client/family in the proper use
of vascular access devices
Extravasation of agents that are vesicants requires specific, immediate attention to
minimize tissue damage. Selection of a neutralizing solution is dependent on vesicant.
Closely monitor the infusion site for evidence of infiltration.
,Intracavitary chemotherapy - ✔Involves the administration of chemotherapy directly into
a body cavity (abdomen, pleural space, or bladder)
A small catheter can be used
Local irritation can be increased, but systemic adverse effects are usually prevented.
In some cases, the medication can be removed following a dwell time
Nursing considerations for intracavity chemotherapy - ✔Inform client that some
discomfort can e present during infusion
Instruct the client to monitor for evidence of infection at the site of administration
Indications for chemotherapy - ✔Can be used to cure a disease, help control its
progression, or as palliative treatment for individuals who have a terminal disease.
Most commonly used for treatment of cancer
May also be used for other disorders, such as autoimmune diseases
Preprocedure considerations for chemotherapy - ✔Because administration is limited
to certified individuals, management of adverse effects is the primary focus of health
care personnel
Instruct the client on findings that indicate potential complications. The client should
report findings immediately.
Immunosuppression/neutropenia complications of chemotherapy - ✔Due to bone
marrow suppression by cytotoxic medications
The most significant adverse effect of chemotherapy
Nursing considerations for immunosuppressoin/neutropenia complications of chemotherapy
- ✔Monitor temperature, white blood cell (WBC) count, and absolute neutrophil count
(ANC).
, A fever greater than 37.8C (100F) should be reported to the provider immediately
Clients who have neutropenia might not develop a high fever or have purulent drainage
even when an infection is present
Monitor skin and mucous membranes for infection (breakdown, fissures, and abscess)
Cultures should be obtained prior to initiating antimicrobial therapy
The risk of serious infection increases as the ANC falls. An ANC less than 1000/mm3 indicates a
weak immune system. The nurse should implement neutropenic precautions, including
placing the client in a private room.
Neutropenic precautions - ✔Have the client remain in the room unless he needs to leave for
a diagnostic procedure or therapy. In this case, place a mask on him during transport.
Protect the client from possible sources of infection (plants, change water in equipment daily).
Have client, staff, and visitors perform frequent hand hygiene. Restrict visitors who are ill.
Avoid invasive procedures that could cause a break in tissue (rectal temperatures, injections,
indwelling urinary catheters) unless necessary.
Keep dedicated equipment (blood pressure machine, thermometer, stethoscope) in the
client's room.
Administer colony-stimulating factors (filgrastim) as prescribed to stimulate WBC production.
Client education on neutropenia - ✔Encourage the client to avoid crowds while
undergoing chemotherapy.
Take temperature daily. Report elevated temperature to the provider.
Avoid food sources that could contain bacteria (fresh fruits and vegetables, undercooked
meat, fish, and eggs; pepper and paprika).
Avoid yard work, gardening, or changing a pet's litter box.
Avoid fluids that have been sitting at room temperature for longer than 1 hr.
Wash all dishes in hot, soapy water or a dishwasher. Wash glasses and cups after each use.
Wash toothbrush daily in the dishwasher or rinse in a bleach solution.
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