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Ateneo de Zamboanga University

College of nursing NURSING SKILLS OUTPUT (NSO) Report No.: 9

CARE OF PATIENTS RECEIVING CHEMOTHERAPY Description: The term chemotherapy (pronounced: kee-mo-ther-uh-pee), which is sometimes shortened to chemo, refers to the use of medications to treat cancer. In chemotherapy, Antineoplastic agents are used in an attempt to destroy tumor cells by interfering with cellular functions and reproduction. Chemotherapy is used primarily to treat systemic disease rather than lesions that are localized and amenable to surgery or radiation. Chemotherapy may be combined with surgery or radiation therapy, or both, to reduce tumor size preoperatively, to destroy any remaining tumor cells postoperatively, or to treat some forms of leukaemia. The goals of chemotherapy (cure, control, palliation) must be realistic because they will define the medications to be used and the aggressiveness of the treatment plan. Materials / Equipment needed: • Chemotherapy drug • IV Set • needles • Alcohol wipe • Protective equipment includes:  Syringe  Disposable surgical gloves  Long sleeves gown  Protective eye goggles  Elastic or knit cuffs Procedures:
1. All chemotherapeutic drug should be prepared according to package insert in class II BSC. Aseptic technique should be followed. 2. Personal protective equipment includes disposable surgical gloves, long sleeves gown and elastic or knit cuffs. Protective eye goggles if no BSC to minimize exposure. 3. Explain the procedure to the patient. 4. Wash hands before and after drug handling. 5. Limit access to drug preparation area 6. Keep labelled drug spill kit near preparation area. Apply gloves before drug handling. 7. Open drug vials/ ampoules away from body. 8. Place absorbent pad on work surface. 9. Wrap alcohol wipe around neck of ampoule before opening. 10.Cover tip of needle with sterilize gauge when expelling air from syringe. 11.Label all chemotherapeutic drugs. 12. Clean up any spill immediately.

CHEW, MARIA ARIANNE REI M. BSN III - E

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 Dosage  Route of administration  Date and time that each agent to be administered.  Physical status  Level of anxiety  Psychological status 8. When a chemotherapy treatment takes a long time.hematocrit. 5. BSN III . infection. Bringing a book to read or a tape to listen to may help pass the time and ease the stress of receiving chemotherapy. decreased deep tendon reflexes. CHEW. Explain the importance of the procedure to the patient. Assess the clients condition including  Most recent report of blood counts including hemoglobin . white blood cells and platelets.The chemotherapy drugs prescription which should have  Name of anti-neoplastic agent.E Page 2 of 4 . RN Date Instructor Diagram/Illustration Ms. Teach the patient on how the procedure is done.January 31 – February 02. Advise the patient that he may prepare for it by wearing comfortable clothes. 4. MARIA ARIANNE REI M. Some patients bring a friend or family member to provide company and support during treatment.  Presence of any complicating condition which could contraindicate chemotherapeutic agent administration i. Review. 3. Clinical Nursing responsibilities: Before the procedure: 1.e. 7. Provide privacy.g antiemetics. 6. Karen V. sedatives etc. The oncologist will determine how much the cancer has spread from the results of x rays and other imaging tests and from samples of the tumor taken during surgery. 2011 Abulencia. or bleeding . Medications to be administered in conjunction with the chemotherapy e. 2. A number of medical tests are done before chemotherapy is started. severe stomatitis .

MARIA ARIANNE REI M. Use gloves when handling chemotherapy drugs and excretions from clients receiving chemotherapy. 3. 7. Observe the 10 Rights After the procedure: 1. Teach client and family to report excessive fluid loss or gain. Dispose all chemotherapy wastes as hazardous materials. increased weakness or ataxia. Teach the client to increase fluid intake to 2500 to 3000 ml/day unless contraindicated. shortness of breath. Anti. Advise Sometimes. persistent. 4. patients taking chemotherapy drugs known to cause nausea are given medications called antiemetics before chemotherapy is administered. Clinical 9.E Page 3 of 4 . Other ways to prepare for chemotherapy and help lessen nausea are:  Regularly eat nutritious foods and drink lots of fluids. implement measures to treat extravasation of vesicant medications if it occurs. Two anti-nausea medications that may be used are Kytril and Zofran. Monitor for signs of renal insufficiency. 3. Karen V. Dispose of all equipment used in chemotherapy preparation and administration in designated containers. 2. paresthesia. 4. 6.  Eat and drink normally until about two hours before chemotherapy. seizures. Use Luer-lock fittings on IV tubing used in delivering chemotherapy. Assess for signs of bleeding and infection. 10. platelet counts. nausea and vomiting/diarrhea. 5. RN Date Instructor Ms.January 31 – February 02. low-fat foods and avoid spicy foods. 8. Monitor client for symptoms of anaphylactic reaction Urticaria (hives). 10. sensation of lump in the throat.  Eat high carbohydrate. headache. pruritus (itching). Assess for signs of bone marrow depression: decreased White blood Cell and Red Blood Cell. BUN. 5. Serum Creatinine CHEW. Asses for electrolyte imbalances. granulocyte. Prevent extravasation of vesicant drugs.  elevated urine specific gravity  Abnormal electrolyte values  Insufficient urine output (< 30 ml/hour)  Elevated BP. 2. Prepare measures when administering chemotherapy. 2011 Abulencia. muscle cramps or twitching. BSN III . 9.emetic drugs help to lessen feelings of nausea. During the procedure: 1. change in level of consciousness. Wear disposable long-sleeves gowns when preparing and administering chemotherapy.

com/adjuvant/breast-cancer-treatment/what-toexpect. Karen V. Clinical Instructor CHEW. 2011 Abulencia. MARIA ARIANNE REI M.Reference: http://www. BSN III .herceptin. RN Date Ms.jsp January 24 – 26.E Page 4 of 4 .