BSA
Where do you find the patient's calculated BSA value in EPIC to confirm it is correct?
In the Storyboard
If there is no consent or the consent is missing, what must the RN do?
Contact provider to get the consent and ensure it is in the file.
Empty chemotherapy bags, tubing, etc get disposed of in WHICH COLORED chemotherapy waste disposal bin?
YELLOW disposal bin
Should emergency medications be released when you release the chemotherapy regimen for the day?
No, only if a reaction occurs
After completing the pre-medications, is another set of vital signs and reassessment of the patient required before starting the chemotherapy regimen?
Yes
Two chemotherapy competent RNs are required to review the orders and recalculate the BSA and actual dose. Your co-worker opens the BSA calculator on the computer and asks you to verify the BSA along with her. Is this acceptable??
No, it is TWO RN independent checks.
Where does the RN go to verify consent in a pre-chemo checklist in EPIC?
Open the patient chart, then "Chart Review", then "Media"
Chemotherapy with residual solution gets disposed of in WHICH COLORED chemotherapy waste disposal bin?
BLACK disposal bin
What is the rescue medication when high doses of methotrexate is given?
Leucovorin
The instructions for cleaning a chemotherapy spill can be found on the Spill Kit box.
True
What is the BSA of a patient who weighs 400kg and is 168cm tall?
BSA = 4.32
Before each chemotherapy/immunotherapy treatment, how many independent checks are done?
Two
What needs to be completed and checked before releasing a chemotherapy order? (2)
1. Pre-treatment orders such as labs, medication, and treatment parameters
2. "OK to Treat" order
Where do you document a possible Extravasation? (2)
1. LDA and nurse's note in EPIC
2. VERGE must be placed
If your patient complains of itchiness and shortness of breath during a blood transfusion, what is your PRIORITY nursing intervention?
Stop the infusion
What is the BSA of a patient whose weight is 65lbs and whose height is 40in tall?
BSA = 0.91
When are independent checks completed? (2)
1. During the BSA calculations
2. When the RN receives the chemotherapeutic agents
The RN is required to verify that the protocol being ordered is correct for the patient's diagnosis. What resource do you use to verify a chemotherapy protocol?
NCCN guidelines/COG guidelines for pediatrics
Who is notified of an Adverse Drug Reaction? (3)
1. Pharmacy
2. RN Manager or Supervisor
3. Physician
What 5 items do you need in place to start the process of a blood transfusion?
1. Consent 2. Type and Cross
3. Physician order 4. Patent IV access
5. Base line vital signs
Calculate the BSA: Ms. Brown is a 55 year old woman being treated for breast cancer. She weighs 125 pounds and her height is 172 cm. What is her BSA?
BSA = 1.64
Just prior to administration of chemotherapy, the intravenous chemotherapy agent(s) must be checked against the original order by two chemotherapy certified nurses to verify these 8 pieces of information
1. dose 5. solution
2. route 6. volume
3. infusion rate 7. infusion time
4. duration 8. expiration date
If you are administering any chemotherapy or biotherapy agent that you are unfamiliar with, where would you find information that would be necessary for you to know? (4)
1. NCCN guidelines/COG guidelines for peds
2. Up to Date
3. Micromedex
4. Oncology pharmacy
If a possible reaction is noted during the chemotherapy administration, what are your next steps? (7)
1. Stop infusion 2. Disconnect the chemotherapy
3. Aspirate as much chemotherapy out of the IV line as possible
4. Activate RRT 5. Get another set of vital signs
6. Activate emergency medications in EPIC
7. Complete a VERGE
What Personal Protective Equipment are you required to wear when administering IV Chemotherapy? (4)
1. Two pairs of nitrile gloves
2. Chemo approved gown
3. Eyewear for possible splashing
4. Mask