Running on Empty (Anemia)
Chemotherapy can lower the production of these three types of blood cells made in the bone marrow, leading to anemia, increased risk of infection, and bruising or bleeding
What are red blood cells, white blood cells, and platelets?
The typical lifespan of platelets is this many days.
What are 7-8 days?
A common consequence of chemotherapy and radiation when treatments suppress bone marrow and damage stem cells
These medications stimulate the bone marrow to increase the production of neutrophils, helping reduce the duration of chemotherapy‑induced neutropenia.
What are hematopoietic growth factors (such as G‑CSF or GM‑CSF)?
Patients with previous transfusion reactions are often premedicated with these two common agents to prevent febrile or allergic reactions.
What are acetaminophen and diphenhydramine?
This type of blood cell has a life span of 90-120 days
Skin and mucosal assessment in patients with low platelets includes these findings
What are ecchymosis, petechiae, oozing from puncture sites, conjunctival hemorrhage, scleral injection, bleeding, and pallor?
Radiation to these bone‑marrow–producing regions can lead to prolonged cytopenias.
What are areas with active bone marrow (pelvis, ribs, sternum, skull, and metaphyses of long bones)?
This medication is approved for the treatment of anemia (low red blood cells) resulting from chemotherapy-induced myelosuppression.
What are Erythropoiesis Stimulating Agents (ESA)
⚬Darepoetin alfa (Aranesp)
⚬Epoetin alfa (Procrit)/ (Epogen)
A prophylactic platelet transfusion is typically indicated when platelet counts fall below this level in a stable, non‑bleeding patient.
What is 10,000?
To prevent or identify causes of anemia, nurses may review laboratory values for deficiencies in these three key nutrients essential for RBC production.
What are iron, folate, and vitamin B12?
This term is defined as a decrease in circulating platelets below the institutional lower limit of normal and is of grave concern when counts fall below ~50,000/μL.
This occurs 7-14 days post-chemotherapy treatment, which is the lowest point of white blood cells
Patients receiving G‑CSF may experience this common side effect, often located in the sternum, pelvis, or long bones—where bone marrow is most active.
What is bone pain?
If a transfusion reaction is suspected—such as chest pain, dyspnea, or rigors—the nurse should perform these two critical immediate actions before calling the provider.
The two most common subjective symptoms a nurse would assess in a patient experiencing chemotherapy-induced anemia are
These rectal interventions should be avoided to reduce bleeding risk in severe thrombocytopenia.
What are enemas, rectal temperatures, and suppositories?
A fever above 38°C (100.4°F) in a neutropenic patient is considered what type of oncologic emergency.
True or False:
Filgrastim- sndz (Zarxio) should not be administered within 24 hours before or after chemotherapy, due to the risk of increasing toxicity to developing neutrophils.
Before administering blood products, nurses must ensure this legal and ethical requirement is obtained from the patient.
When teaching oncology patients with anemia, nurses should emphasize the importance of reporting symptoms early. Along with fatigue and lightheadedness, patients should be instructed to notify the care team if they experience this respiratory change that may signal decreased oxygen‑carrying capacity.
What is shortness of breath (dyspnea)?
https://www.canva.com/design/DAHKi1Y5wzA/HmrhPER8KAWx_hwLL5SYVQ/view
Outline two key elements of a safe plan of care for chemotherapy‑induced thrombocytopenia that nurses should implement and reinforce with patients/caregivers.
What are (any two): establishing a schedule for monitoring blood counts and follow‑up; maintaining a current type and screen for frequent transfusions; educating on activity planning and energy conservation; teaching reportable signs/symptoms of bleeding (e.g., mucosal bleeding, new/worsening headaches, SOB, pallor, neurologic changes); and holding anticoagulation when platelets are <50,000/μL per provider orders/policy.
This simple, nonpharmacologic intervention is the single most important strategy for preventing infection in neutropenic patients.
What is strict hand‑washing (hand hygiene)?**
This medication can be given for chemotherapy-induced thrombocytopenia
What is Nplate (Romiplostim)?
This acute transfusion reaction occurs when rapid infusion leads to fluid overload and pulmonary edema, and is distinguished from anaphylaxis or hemolytic reactions by symptoms such as dyspnea, hypertension, and crackles.
What is TACO (Transfusion- Associated Circulatory Overload)?