Question 1

Plant Alkaloids:
Specific Drugs

Accepted Answer

Vinca alkaloids
Taxanes
Podophyllotoxins

Question 2

Vinca alkaloids
Specific Drugs

Accepted Answer

Interfere with amino acid production in S phase and formation of microtubules in M phase

Question 3

Taxanes
Specific Drugs

Accepted Answer

Interfere in M-phase with microtubules

Question 4

Podophyllotoxins
Specific Drugs

Accepted Answer

Cells are unable to divide since cells are stopped during S and G2 phases by the podophyllotoxins

Question 5

Antimetabolites: 
Specific Drugs

Accepted Answer

Interfere with synthesis of RNA and DNA, make it impossible for cancerous cell to divide into two daughter cells

Question 6

Drugs are used to treat:
Specific Drugs

Accepted Answer

Leukemia, lymphoma, solid tumors, autoimmune diseases

Question 7

Alkylating agents:
Nonspecific Drugs

Accepted Answer

Change cell to more alkaline environment, which in turn damages the cell

Question 8

Antineoplastic antibiotics: 
Nonspecific Drugs

Accepted Answer

Interfere with DNA and RNA synthesis, delaying or inhibiting cell division

Question 9

Miscellaneous antineoplastic arugs:
Nonspecific Drugs

Accepted Answer

Number of drugs are used for antineoplastic actions, do not belong to any one category

Question 10

Nonspecific Drugs
Adverse Reactions

Accepted Answer

Nausea and vomiting from highly emetic drugs or potential of IV extravasation of irritating solutions

Question 11

Adverse reactions common to antineoplastic drugs:

Accepted Answer

Bone marrow suppression; Stomatitis; Diarrhea; Hair loss 
Leukopenia and thrombocytopenia may cause cycles of chemotherapy to be delayed until blood cell counts can be raised 
Damage gonads causing fertility problems

Question 12

Contraindications:
Antineoplastic drugs
Nonspecific Drugs

Accepted Answer

Leukopenia; Thrombocytopenia; Anemia; Serious infections; Renal disease; Hypersensitivity to drug; During pregnancy or lactation

Question 13

Precautions:
Antineoplastic drugs
Nonspecific Drugs

Accepted Answer

Renal or hepatic impairment; Active infection; Debilitating illnesses; Those who have completed treatment with other antineoplastic drugs or radiation therapy

Question 14

Nursing Process: Assessment 
Preadministration assessment:

Accepted Answer

Type & location of the neoplastic lesion
Stage of the disease. Pt’s general physical & emotional condition. Anxiety or fears the pt may have regarding chemotherapy. Previous, concurrent treatments. Current nonmalignant disease or disorder. The patient’s

Question 15

Nursing Process: Assessment 
Ongoing assessment:

Accepted Answer

The patient’s general condition 
The patient’s individual response to the drug
Adverse reactions that may occur
Guidelines established by the primary health care provider or hospital 
Results of periodic laboratory tests and radiographic scans

Question 16

Nursing Process: Nursing Diagnoses

Accepted Answer

Imbalanced nutrition: Less than body requirements
Fatigue
Risk for injury 
Risk for infection 
Disturbed body image 
Anxiety
Impaired tissue integrity

Question 17

Nursing Process: Planning 

Expected outcomes:

Accepted Answer

An optimal response to therapy
Support of patient needs related to the management of adverse reactions
Understanding of prescribed treatment modalities

Question 18

Nursing Process: Implementation 

Promoting an optimal response to therapy:

Guidelines established by the setting for care:

Accepted Answer

Increase vital signs, if patient’s condition changes  
Consult references to obtain information regarding preparation and administration of drug, average dose ranges, all adverse reactions, warnings and precautions given by manufacturer

Question 19

Nursing Process: Implementation 

Promoting an optimal response to therapy:
Protection of the Provider

Accepted Answer

The Occupational Safety and Health Administration (OSHA) guidelines 
Nurses need to be protected during administration and cleanup from accidental ingestion, inhalation, or absorption of drugs

Question 20

Nursing Process: Implementation 

Promoting an optimal response to therapy:
Oral Administration

Accepted Answer

Administer antineoplastic drugs orally 
GI tract  functions normally when oral drugs are well absorbed

Question 21

Nursing Process: Implementation 

Promoting an optimal response to therapy:
Parenteral Administration

Accepted Answer

Give injection into large muscles using Z-track method  
Sites should be rotated, charted appropriately if the injections are given frequently

Question 22

Nursing Process: Implementation
Monitoring and Managing patient needs
Imbalanced Nutrition: Less than body requirements

Accepted Answer

nutritional status of patient before and during treatment
small, frequent meals to stimulate appetite
eat healthy meals high in(protein) 
body weight weekly
Provide soft or liquid food
report white patches on tongue, throat, gums; Burning sensation;

Question 23

Nursing Process: Implementation

Monitoring and managing patient needs

Fatigue, infection and injury: Myelosuppression

Accepted Answer

Help patient learn to prioritize activity to conserve energy
Monitor patients with thrombocytopenia for bleeding tendencies 
Apply pressure to injection site for 3 to 5 minutes to prevent bleeding into tissue and formation of hematoma 
avoid use of ele

Question 24

Nursing Process: Implementation

Monitoring and managing patient needs
Disturbed body image

Accepted Answer

Inform patient that hair loss may occur if hair loss is associated with antineoplastic drug being given
Forewarn patient that hair loss may occur suddenly and in large amounts
Assist in making plans for purchase of wig or cap to disguise hair loss until

Question 25

Nursing Process: Implementation

Monitoring and managing patient needs 
Anxiety

Accepted Answer

Offer empathetic, emotional support to patient, and family members

Question 26

Nursing Process: Implementation

Monitoring and managing patient needs 
Impaired tissue integrity

Accepted Answer

Instruct patient about  adverse reaction as it can be both surprising and painful
Ensure that extravasation protocol orders are signed and extravasation kit is on unit before vesicant drugs are administered 

Monitor IV site continuously and check for

Question 27

Nursing Process: Implementation

Educating the patient and family:

Accepted Answer

Take drug only as directed and do not alter the dose unless advised
All recommendations given by the primary health care provider are important
Effectiveness or action of the drug could be altered if these directions are ignored 
Keep all appointments

Question 28

Nursing Process: Evaluation

Accepted Answer

The therapeutic effect is achieved 
Adverse reactions are identified, reported and managed 
Anxiety is reduced

Antineoplastic Drugs

LippinCott Williams and Wilkins Chapter 51

Question	Answer
Plant Alkaloids: Specific Drugs	Vinca alkaloids Taxanes Podophyllotoxins
Vinca alkaloids Specific Drugs	Interfere with amino acid production in S phase and formation of microtubules in M phase
Taxanes Specific Drugs	Interfere in M-phase with microtubules
Podophyllotoxins Specific Drugs	Cells are unable to divide since cells are stopped during S and G2 phases by the podophyllotoxins
Antimetabolites: Specific Drugs	Interfere with synthesis of RNA and DNA, make it impossible for cancerous cell to divide into two daughter cells
Drugs are used to treat: Specific Drugs	Leukemia, lymphoma, solid tumors, autoimmune diseases
Alkylating agents: Nonspecific Drugs	Change cell to more alkaline environment, which in turn damages the cell
Antineoplastic antibiotics: Nonspecific Drugs	Interfere with DNA and RNA synthesis, delaying or inhibiting cell division
Miscellaneous antineoplastic arugs: Nonspecific Drugs	Number of drugs are used for antineoplastic actions, do not belong to any one category
Nonspecific Drugs Adverse Reactions	Nausea and vomiting from highly emetic drugs or potential of IV extravasation of irritating solutions
Adverse reactions common to antineoplastic drugs:	Bone marrow suppression; Stomatitis; Diarrhea; Hair loss Leukopenia and thrombocytopenia may cause cycles of chemotherapy to be delayed until blood cell counts can be raised Damage gonads causing fertility problems
Contraindications: Antineoplastic drugs Nonspecific Drugs	Leukopenia; Thrombocytopenia; Anemia; Serious infections; Renal disease; Hypersensitivity to drug; During pregnancy or lactation
Precautions: Antineoplastic drugs Nonspecific Drugs	Renal or hepatic impairment; Active infection; Debilitating illnesses; Those who have completed treatment with other antineoplastic drugs or radiation therapy
Nursing Process: Assessment Preadministration assessment:	Type & location of the neoplastic lesion Stage of the disease. Pt’s general physical & emotional condition. Anxiety or fears the pt may have regarding chemotherapy. Previous, concurrent treatments. Current nonmalignant disease or disorder. The patient’s
Nursing Process: Assessment Ongoing assessment:	The patient’s general condition The patient’s individual response to the drug Adverse reactions that may occur Guidelines established by the primary health care provider or hospital Results of periodic laboratory tests and radiographic scans
Nursing Process: Nursing Diagnoses	Imbalanced nutrition: Less than body requirements Fatigue Risk for injury Risk for infection Disturbed body image Anxiety Impaired tissue integrity
Nursing Process: Planning Expected outcomes:	An optimal response to therapy Support of patient needs related to the management of adverse reactions Understanding of prescribed treatment modalities
Nursing Process: Implementation Promoting an optimal response to therapy: Guidelines established by the setting for care:	Increase vital signs, if patient’s condition changes Consult references to obtain information regarding preparation and administration of drug, average dose ranges, all adverse reactions, warnings and precautions given by manufacturer
Nursing Process: Implementation Promoting an optimal response to therapy: Protection of the Provider	The Occupational Safety and Health Administration (OSHA) guidelines Nurses need to be protected during administration and cleanup from accidental ingestion, inhalation, or absorption of drugs
Nursing Process: Implementation Promoting an optimal response to therapy: Oral Administration	Administer antineoplastic drugs orally GI tract functions normally when oral drugs are well absorbed
Nursing Process: Implementation Promoting an optimal response to therapy: Parenteral Administration	Give injection into large muscles using Z-track method Sites should be rotated, charted appropriately if the injections are given frequently
Nursing Process: Implementation Monitoring and Managing patient needs Imbalanced Nutrition: Less than body requirements	nutritional status of patient before and during treatment small, frequent meals to stimulate appetite eat healthy meals high in(protein) body weight weekly Provide soft or liquid food report white patches on tongue, throat, gums; Burning sensation;
Nursing Process: Implementation Monitoring and managing patient needs Fatigue, infection and injury: Myelosuppression	Help patient learn to prioritize activity to conserve energy Monitor patients with thrombocytopenia for bleeding tendencies Apply pressure to injection site for 3 to 5 minutes to prevent bleeding into tissue and formation of hematoma avoid use of ele
Nursing Process: Implementation Monitoring and managing patient needs Disturbed body image	Inform patient that hair loss may occur if hair loss is associated with antineoplastic drug being given Forewarn patient that hair loss may occur suddenly and in large amounts Assist in making plans for purchase of wig or cap to disguise hair loss until
Nursing Process: Implementation Monitoring and managing patient needs Anxiety	Offer empathetic, emotional support to patient, and family members
Nursing Process: Implementation Monitoring and managing patient needs Impaired tissue integrity	Instruct patient about adverse reaction as it can be both surprising and painful Ensure that extravasation protocol orders are signed and extravasation kit is on unit before vesicant drugs are administered Monitor IV site continuously and check for
Nursing Process: Implementation Educating the patient and family:	Take drug only as directed and do not alter the dose unless advised All recommendations given by the primary health care provider are important Effectiveness or action of the drug could be altered if these directions are ignored Keep all appointments
Nursing Process: Evaluation	The therapeutic effect is achieved Adverse reactions are identified, reported and managed Anxiety is reduced

"Know" box contains:
Time elapsed:
Retries: