CHEMO BASICS
What does R-CHOP stand for?
Rituximab, Cyclophosphamide, Doxorubicin, Vincristine, Prednisone
What PPE is required when handling hazardous drugs / contaminated fluids?
Chemo-tested gloves and gown (and sometimes face/eye protection)
What medication class is often given before chemo to prevent nausea?
Antiemetics (ondansetron, etc.)
What is the purpose of “flushing” a port?
To maintain patency and prevent clotting
A patient is 30 minutes late for Neulasta injection. What do you do?
Attempt to call patient, notify charge nurse – make plans to ensure patient gets injection
Name one chemotherapy drug that can cause peripheral neuropathy.
Vincristine, Oxaliplatin, Taxanes
Where should chemotherapy waste be disposed of?
In yellow chemo bins
Name one sign of an infusion reaction.
Rash, fever, chills, dyspnea, low blood pressure, swelling
True or False: You must check for a blood return before giving chemo
True
A patient develops hives mid-infusion. What is your priority?
Stop infusion, assess, notify provider, treat per hypersensitivity protocol
Before giving chemotherapy, name 3 things the nurse must verify.
Correct patient, correct drug/dose, consent, labs, vital signs
What should you do FIRST if a vesicant extravasates?
Stop the infusion
True or False: Mucositis pain from chemotherapy is best managed by using alcohol-based mouth rinses to keep the mouth clean
False, alcohol-based rinses can make mucositis WORSE
After accessing a port, what type of dressing should be applied?
Sterile dressing
Which vaccine type should immunocompromised chemo patients avoid?
Live vaccines
Which blood cell type is most affected by chemotherapy?
Neutrophils (leading to neutropenia)
True or False: Oral chemotherapy pills can be handled with bare hands.
False
Name a possible late side effect of anthracyclines (like doxorubicin)
Cardiotoxicity/Heart damage
If you cannot get blood return from a port, what is your next step?
Troubleshoot position, ask patient to cough, raise arm, cathflo if sure of placement
A patient asks, “Why can’t I take my herbal supplements during chemo?”
Potential drug interactions
True or False: Monoclonal antibodies are considered targeted therapy, not traditional chemotherapy.
True
What is the spill kit used for?
Cleaning up hazardous drug spills safely
What drug is used as a rescue for high-dose methotrexate?
Leucovorin
What type of needle is used to access a port?
Non-coring (Huber) needle
A patient forgot to take their pre-chemo steroids. What’s your next step?
Notify provider—treatment may need to be delayed / premeds administered before chemo