Chemotherapy and Radiation Theory Exam 5

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2 types of chemotherapy

�Cell Cycle Specific
�Cell Cycle Non-Specific

Use of chemical as a systemic therapy for cancer

ChemotherapyW

One tx does not work for everyone
Will be used with other tx options: radiation, surgical procedure

Chemo

Work on specific phases of cell cycle: Kill cell @ different phase

Cell Cycle Specific

Tx for solid tumors, and hemtalocical cancers

Cell cycle specific Chemo

Works in proliferative, reproductive and resting phase

Cell cycle specific

Work on all phases of cycle

Cell cycle non specific

These drugs are more potent =
Increased incidence of SE "Don't work for all individuals

Cell cycle non specific

Drug regimen chooses for chemo is chosen on?

Based on evidence supporting use of specific cancers
Ex: lung tx= decreased based on pt will determine meds

Dosing is based on body weight and height

CHemo

Widely used, available due to research
This will be done at home sometimes= Teach safe handling and storage

Oral Chemo

*Most common
Nurses will be trained
-Monitor site
"Port implanted"
Irriating= put on larger vein but may just have peripheral IV

IV chemo

When cancer is in CNS
Meds not cross blood brain barrier put right in CSF
Done with lumbar puncture

Intrathecal Chemo

Medication is administers in subacranoid space- "Monitor site"
"Trained"
Repeated= device/resevior inserted= med inserted could be here

Intrathecal

Effects of Chemo on tissues?

�Acute Toxicity
�Delayed Effects
�Chronic Toxicities

Complications that occur during or right after chemo

Acute Toxicity

-Can be an anaphylactic reaction= reacting to med itself
-Sensitivity to med
-Establish dysrytmias= monitor pt completely while getting medication and after

Acute Toxicity

Iv can be damaging to tissues.
2 types?

Erritant
Visicant

Med that can damage the vein and cause phelbitis while getting IV chemo

Erritant

If leaks out, it will damage tissue and cause breakdown and can lead to tissue necrosis

Visicant

You will see multiple times hour or days after chemo

Delayed Effects

Delayed effects of chemo?

1. N/V
2. mucocytisis= not hungry
3. Alopecia
4. bowel complication- constipation or diarrhea
5.Rash

Communication- could experience what to do, what to watch for

Delayed effects

Long term : Damage to heart , lungs, kidneys, liver
Can happen months or years after getting "can re-pop up as another cancer years down the road

Chronic Toxciticites of CHemo

Small packet of energy that is delivered to a site that breaks down actual DNA bond and causes cell death

Radiation

Can be focused on one small area- won't do as much for other areas of the body

Radiaion

______ and ______ can be used together or separate

Chemo
Radiation

Types of radiation?

�Low-energy
�High-energy

Quick burst of energy superficial= areas that we need to concentrate short burst

Low energy Radiation

Beam is passed through and it will not expand energy until it gets to a greater depth. Ability to reach deeper tumors and not damage superficial skin

High energy Radiation

Used with deeper tumors and concentrate more energy or deeper area

High energy Radiation

Administration for Radiation?

�External
�Internal (Brachytherapy)

*most common, via machine through tumor "Gamma knife

External

Radioactive materail is actually implanted via medications or beads

Internal (Bradytherapy)

Allow direct delivery of radiation with minimal exposure to surrounding healthy tissue

Internal (Bradytherapy)

Good education to pts
-Understand limitations with radiation
-PT will be radioactive and it goes by Half life of med
-Can be radioactive to others "Perform cares away from family members

Radiation

As long as they have this, they are radioactive "protect family and themselves

Implantable Beads 'radiation'

Clustering of care in certain amount of the radioactive material

Radiation

Side effects of chemo or radiation?

�Bone Marrow Suppression
�Fatigue
�Gastrointestinal
�Skin Reactions
�Pulmonary
�Cardiovascular
�Cognitive
�Reproductive

Mostly with chemo, but also with radiation
-Increased infection= Neutropenia
-Increased risk of hemmorrage because of decreased platelets- no clotting
-More bruising and bleeds
-Increased fall risk

Bone Marrow Suppression

Due to anemia because chemo is breaking down blood cell production
-Could be from disease itself or from tx options
Clustering cares, schedule apps in morning, rest"
Diet Is supporting

Fatigue

These side effects are huge !!

Gastrointestinal

GI SE?

-N/V
-Mucocytisis
-Constipation
-Diarrhea
-Hydration= what is going in, is coming out
-Nutrition to get better= no eating= no healing

radiation treatment area:
1. Gently cleanse the skin in the treatment field using a mild soap (Ivory, Dove), tepid water, a soft cloth, and a gentle patting motion. Rinse thoroughly and pat dry.
2. Apply nonmedicated, nonperfumed, moisturizing lotion or c

Teaching with Radiation Skin Reactions

-Alopecia
-Skin breakdown= prevent infection and promote wound healing
-No lotions, harsh chemicals, no soaps or detergants

Skin reactions

No heating pads= no protection & no ice packs on direct areas

Skin reactions

Progressive lung damage
-hard to tell SE vs disease
-Progress, support oxygen, watch meds that could cause respiratory depression

Pulmonary

Especially if radiation is done to chest= possibility to affect pericardium or myocardium
Pre- existing cardiovascular disease are most @ risk

Cardiovascular

Can happen any time with chemo and radiation, but mostly seen after tx
"CHEMO BRAIN"
Can affect ADL's= can't care for themselves, jobs, memory "Resources support

Cognitive

Feel like they are in a mental fog
May lAT SHORT TIME AND CLEAR UP OR COULD LAST YEARS AFTER TX DEPENDING ON TYPE AND # OF TX

CHEMO BRAIN

This varies amount patients, meds, types
"provide support" py and partner have support, resources, options and choices provided

Reproductive