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Unfolding Case Study

c. Guadelupe is of childbearing age. It is important to confirm she is not pregnant prior to initiating chemotherapy, as these agents can have harmful effects on the fetus.
a. Adjuvant therapy is given after initial treatment with surgery or radiation.
b. Taxol and other taxenes are likely to cause hypersensitivity reactions in clients receiving them. Premedicating the client with certain medications such as steroids, diphenhydramine, and histamine blockers will decrease the risk of these reactions.
a. Tamoxifen is an antiestrogen hormonal agent. Taking this medication will result in amenorrhea, or the absence of menstrual cycles.

Review Questions

c. Targeted therapy is administered to selectively kill cancer cells without harming healthy cells.
a. The nurse should continue with the treatment because the client’s lifetime total of doxorubicin is within the maximum lifetime limit of 550 mg/m2.
a. Leucovorin is administered with fluorouracil to enhance the effectiveness of fluorouracil.
d. To avoid infection, the client with myelosuppression should avoid cat litter boxes.
c. Pembrolizumab heightens T-lymphocyte activity, predisposing clients to the development of immune-mediated conditions.
c. Tumor lysis syndrome occurs when cancer cells are destroyed, releasing cellular debris and electrolytes into the blood, resulting in hypocalcemia, hyperkalemia, hyperphosphatemia, and acidosis.
d. Tamoxifen, an antiestrogen administered to treat breast cancers that are hormone-receptor positive, is taken for 5 years.
b. Doxorubicin should not be administered to clients who have a left ventricular ejection fraction less than 55%. Since this client has an ejection fraction of 58%, the nurse would administer the medication as prescribed.
b. Because this client has a low absolute neutrophil count, the nurse anticipates an order for filgrastim to stimulate stem cell production of white blood cells.
a. Rituximab has a high risk for causing a sensitivity reaction, so the client must be premedicated with diphenhydramine and acetaminophen.

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