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Questions and Answers
Before chemotherapy administration, the nurse should review the prescription for the Name of the _______________ agent.
anti-neoplastic
During drug administration, the nurse should wear personal protective equipment like disposable surgical gloves and a long sleeves gown to maintain _______________ during handling.
aseptic technique
The nurse should ensure accurate preparation of the chemotherapy agent by checking the _______________ for correct reconstitution.
expiry date
The calculation of drug dosage should be based on the patient's _______________ area.
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For oral drug administration, it is important to emphasize the compliance with the prescribed schedule to the patient for optimal _______________.
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For intramuscular and subcutaneous drug administration, non-vesicants like L-asperaginase should be used to prevent _______________.
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Aseptic technique should be followed to minimize exposure and prevent _______________ during drug handling.
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The nurse should wash hands before and after drug handling to maintain proper _______________.
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Limiting access to the drug preparation area helps to ensure proper handling and prevent unauthorized _______________ of medications.
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The nurse should assess the patient's understanding of the chemotherapeutic agents and administration procedures to ensure proper _______________ of treatment.
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New venepuncture site daily if peripheral access is used. Central venous access for 24 hrs vesicants infusion. Administration of drug in a quiet, unhurried environment. Testing vein patency without using chemotherapeutic agents. Providing adequate drug dilution. Careful observation of access site and extremity throughout the procedure. Ensuring blood return from I/V site before, during, and after vesicant drug infusion. Educating patients regarding symptoms of drug infiltration e.g. pain, burning, stinging sensation at I/V site. Extravasation management at peripheral site. According to hospital policy and approved antidote should be readily available. Stop the drug -leave the needle or catheter in place; aspirate any residual drug and blood in the I/V tubing, needle or catheter, and suspected infiltration site; instill the I/V antidote; remove the needle. Nursing Management of common side effects of Chemotherapeutic Drugs. Nausea & Vomiting. Avoid eating/drinking for 1-2 hrs prior to and after chemotherapy administration. Eat frequent, small meals. Avoid greasy & fatty foods and very sweet foods & candies. Avoid unpleasant sights, odors & tastes. Follow a clear liquid diet. If vomiting is severe inform the physician. Sip liquids slowly or suck ice cubes and avoid drinking a large volume of water if vomiting is present. Administer antiemetic to prevent or minimize nausea.
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Avoid eating/drinking for 1-2 hrs prior to and after ______ administration. Eat frequent, small meals. Avoid greasy & fatty foods and very sweet foods & candies. Avoid unpleasant sights, odors & tastes. Follow a clear liquid diet. If vomiting is severe inform the physician. Sip liquids slowly or suck ice cubes and avoid drinking a large volume of water if vomiting is present. Administer antiemetic to prevent or minimize nausea.
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Central venous access for 24 hrs _____ infusion. Administration of drug in a quiet, unhurried environment. Testing vein patency without using chemotherapeutic agents. Providing adequate drug dilution. Careful observation of access site and extremity throughout the procedure. Ensuring blood return from I/V site before, during, and after vesicant drug infusion. Educating patients regarding symptoms of drug infiltration e.g. pain, burning, stinging sensation at I/V site. Extravasation management at peripheral site. According to hospital policy and approved antidote should be readily available. Stop the drug -leave the needle or catheter in place; aspirate any residual drug and blood in the I/V tubing, needle or catheter, and suspected infiltration site; instill the I/V antidote; remove the needle.
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New venepuncture site daily if peripheral access is used. Central venous access for 24 hrs _____ infusion. Administration of drug in a quiet, unhurried environment. Testing vein patency without using chemotherapeutic agents. Providing adequate drug dilution. Careful observation of access site and extremity throughout the procedure. Ensuring blood return from I/V site before, during, and after vesicant drug infusion. Educating patients regarding symptoms of drug infiltration e.g. pain, burning, stinging sensation at I/V site. Extravasation management at peripheral site. According to hospital policy and approved antidote should be readily available. Stop the drug -leave the needle or catheter in place; aspirate any residual drug and blood in the I/V tubing, needle or catheter, and suspected infiltration site; instill the I/V antidote; remove the needle.
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Nursing Management of common side effects of ______ Drugs. Nausea & Vomiting. Avoid eating/drinking for 1-2 hrs prior to and after chemotherapy administration. Eat frequent, small meals. Avoid greasy & fatty foods and very sweet foods & candies. Avoid unpleasant sights, odors & tastes. Follow a clear liquid diet. If vomiting is severe inform the physician. Sip liquids slowly or suck ice cubes and avoid drinking a large volume of water if vomiting is present. Administer antiemetic to prevent or minimize nausea.
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Providing adequate drug dilution. Careful observation of access site and extremity throughout the procedure. Ensuring blood return from I/V site before, during, and after ______ drug infusion. Educating patients regarding symptoms of drug infiltration e.g. pain, burning, stinging sensation at I/V site. Extravasation management at peripheral site. According to hospital policy and approved antidote should be readily available. Stop the drug -leave the needle or catheter in place; aspirate any residual drug and blood in the I/V tubing, needle or catheter, and suspected infiltration site; instill the I/V antidote; remove the needle. Nursing Management of common side effects of Chemotherapeutic Drugs. Nausea & Vomiting. Avoid eating/drinking for 1-2 hrs prior to and after chemotherapy administration. Eat frequent, small meals. Avoid greasy & fatty foods and very sweet foods & candies. Avoid unpleasant sights, odors & tastes. Follow a clear liquid diet. If vomiting is severe inform the physician. Sip liquids slowly or suck ice cubes and avoid drinking a large volume of water if vomiting is present. Administer antiemetic to prevent or minimize nausea.
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Use the smallest gauge needle possible for the viscosity of the medication Intravenous is a ____________ method
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Absorption is more reliable -route is required for administration of vesicants and it also reduces the need of repeated injection. Because the I/V provides direct access to the circulatory system, the potential for infection and life threatening sepsis is a serious complication of I/V chemotherapy. Inspect the solution, container and tubing for signs of contamination including particles, discoloration, cloudiness, and cracks or tears in bottle or bag. Aseptic technique to be followed. Prepare according to manufacturers directions. Select a suitable vein-Large veins on the forearm are the preferred site -Use distal veins first, and choose a vein above areas of flexion. For non-vesicant drugs, use the distal veins of the hands (metacarpal veins): then the veins of the forearms(basilic and cephalic veins) For vesicants, use only the veins of the forearms Avoid using the metacarpal and radial areas Avoid the antecubital fossa and the wrist because an extravasation in these areas can destroy nerves and tendons, resulting in loss of function Peripheral sites should be changed daily before administration of vesicants Avoid the use of small lumen veins to prevent damage due to friction and the decreased ability to dilute acidic drugs and solutions Select the shortest catheter with the smallest gauge appropriate for the type and duration of the infusion (21g to 25g for I/V medications and 19 g for blood products) Avoid a vein which has been used for venous access within the past 24 hrs to prevent leakage from a prior puncture site Prevent trauma and infection at the insertion site Apply a small amount of iodine based antiseptic ointment over the insertion site & cover the area with sterile gauze Intravenous Chemotherapy Via Central Vein Infusion (Hickman Catheter) Documentation-chemotherapeutic drugs, dose, route ,and time Premedications, postmedications, prehydration and other infusions and supplies used for chemotherapy regimen Any complaints by the patient of discomfort and symptoms experienced before, during, and after chemotherapeutic infusion Disposal of supplies and unused drugs Do not clip or recap needles or break syringes Place all supplies used intact in a leak proof ,puncture proof, appropriate labeled container Place all unused drugs in containers in a leak proof, puncture proof, appropriately labeled container Dispose of containers filled with chemotherapeutic supplies and unused drugs in accordance with regulations of hazardous wastes. Management of chemotherapeutic spill Should be cleaned up immediately by properly protected personnel trained in the appropriate procedure Should be identified with a warning sign so that other person will not be contaminated Spill kit: Respirator mask for air borne powder spills Plastic safety glasses or goggles Heavy duty rubber gloves Absorbent pads to contain liquid spills Absorbent towels for clean up after spills Small scoop to collect glass fragments Two large waste disposal bags Protective disposable gown Containers of detergent solution and clear tap water for post spill clean up Puncture proof and leak proof container approved for chemotherapy waste disposal Approved, specially labeled, impervious laundry bag Spill on hard surface Restrict area of spill Obtain drug spill kit Put on protective gown, gloves, goggles Open waste disposal bags Place absorbent pads gently on the spill; be careful not to touch spill Place absorbent pad in waste bag Cleanse surface with absorbent towels using detergent solution and wipe clean with clean tap water Place all contaminated materials in the bag Wash hands thoroughly with soap and water Spill on personnel or patient Restrict area of spill Obtain drug spill kit Immediately remove contaminated protective garments or linen Wash affected skin area with soap and water; if eye exposure-immediately flood the affected eye with water for at least 5 mts; obtain medical attention promptly Notify the physician if drug spills on patient Document the spill Staff Education All personnel involved in the care should receive an orientation to chemo drugs: known risk, relevant techniques and procedures for handling, proper use of protective equipment and materials, spill procedures, and medical policies covering personnel handling chemo agents; personnel handling blood, vomitus, or excreta from patients who have received chemotherapy should wear disposable gloves and gowns to be appropriately discarded after use Extravasation management Extravasation: accidental infiltration of vesicant or irritant chemotherapeutic drugs from the vein into the surrounding tissues at the I/V site Vesicant: agent that can produce a blister and /or tissue destruction Irritant: agent that is capable of producing venous pain at the site of and along the vein with or without an inflammatory reaction Injuries that may occur as a result of extravasation -sloughing of tissue , infection, pain ,and loss of mobility of an extremity Prevention of extravasation (Nursing responsibilities) Knowledge of drugs with vesicant potential Skill in drug administration Identification of risk factors e.g. Write 10 "fill in the blank" statements using the content above. Provide the missing word as the answer. Focus on topics: chemotherapy administration procedures, medication preparation, drug administration routes, aseptic technique, dosage calculation. Write in English language.
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Study Notes
Chemotherapy Administration Procedures
- Before administration, review the prescription for the name of the chemotherapy agent.
- Wear personal protective equipment (PPE) such as disposable surgical gloves and a long-sleeved gown to maintain safety during handling.
- Ensure accurate preparation of the chemotherapy agent by checking the label for correct reconstitution.
- Calculate drug dosage based on the patient's body surface area.
Medication Preparation
- Use aseptic technique to minimize exposure and prevent infection during drug handling.
- Wash hands before and after drug handling to maintain proper hygiene.
- Limit access to the drug preparation area to ensure proper handling and prevent unauthorized access to medications.
Drug Administration Routes
- Intravenous (IV) administration is a parenteral method that provides direct access to the circulatory system.
- IV administration is required for vesicants and reduces the need for repeated injections.
- Central venous access is used for 24-hour vesicant infusion.
Aseptic Technique
- Inspect the solution, container, and tubing for signs of contamination before administration.
- Prepare medications according to manufacturers' directions.
- Select a suitable vein, avoiding small lumen veins and areas of flexion.
Dosage Calculation
- Calculate drug dosage based on the patient's body surface area.
- Ensure accurate calculation to prevent overdosing or underdosing.
Nursing Management of Side Effects
- Manage nausea and vomiting by avoiding eating/drinking 1-2 hours prior to and after chemotherapy administration.
- Educate patients on symptoms of drug infiltration, such as pain, burning, and stinging sensation at the IV site.
- Administer antiemetics to prevent or minimize nausea.
Extravasation Management
- Identify vesicant and irritant chemotherapeutic drugs that can cause extravasation.
- Manage extravasation by stopping the drug, leaving the needle or catheter in place, and aspirating any residual drug and blood in the IV tubing, needle, or catheter.
- Instill the IV antidote and remove the needle.
Staff Education
- Educate personnel involved in chemotherapy care on the risks, techniques, and procedures for handling chemotherapy agents.
- Ensure personnel understand proper use of protective equipment and materials, spill procedures, and medical policies covering personnel handling chemotherapy agents.
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Description
Test your knowledge on the different methods of administering chemotherapy, including intravenous (IV) administration and the use of central venous catheters. Learn about the importance of using the smallest gauge needle and the benefits of IV administration for chemotherapy drugs.
