Administration
What do you need to check prior to administration?
List 3 things
Consent
Prescriber treatment note
Prescriber orders match an approved and/or SOC protocol
Pre-treatment Labs
Patient Education
Supportive Medications
IV line/Blood Return
Baseline assessment ie Ht, wt, BSA
Chemo/bio worksheet
Independent Double Check by chemo competent RN
Orders for treatment of hypersensitivity or adverse drug reaction
The first step in preparing to administer chemotherapy
What is check the drug container's label against the prescriber order?
A small spill is considered <= how many ml?
What is 5 ml?
When you first notice an extravasation, this is the first step you should take...
What is stop and disconnect the infusion?
This is the most emetogenic chemotherapy in the world
What is cisplatin?
Once you finish administering chemotherapy, it should be flushed with what minimum volume and diluent?
What is at least 20 ml normal saline or compatible IV solution?
How many times is the treatment & drugs checked prior to administration per ONS/ASCO Standards?
6 times
In order to identify threat and risk properties of the spilled chemotherapy, you would use this
What is the Safety Data Sheet (SDS)?
Once you aspirate as much as possible and remove the cannula of the IV, the next step is this
What is outline the extravasated area?
This chemotherapy class has high rates of hypersensitivity and is usually infused first when multiple chemotherapies are given in one session
What are taxanes?
You should do this when hanging HD or handling bodily waste of patients s/p chemotherapy
What is wear appropriate chemotherapy personal protective equipment (PPE)?
This is the type of transfer device used to administer chemotherapy
What is a closed system transfer device?
What is the necessary PPE for cleaning up a HD spill?
NIOSH approved N-95
2 pairs of chemo gloves
shoe covers
chemo gown
Goggles/Face shield
In order to neutralize a vincristine extravasation, you would use this antidote and compress type
What is hyaluronidase and warm compress?
This chemotherapy should never be given intrathecally and will almost always cause neuropathy
What is vincristine?
When documenting, blood return must be present during these times
What are pre, during & post infusion?
Enter the infusion rate and volume into the infusion pump requires this type of check
What is a double check?
Once the incident is resolved, you need to enter it here
and who do you call?
What is a Event Report?
Safety Number attached to Policy
This popular "red" chemotherapy class would require a dry cold compress to localize in case of extravasation
What are anthracyclines?
This chemotherapy class requires protection from light and needs to be monitored for lifetime cumulative dosing
What are anthracyclines ("-rubicins")?
The acceptable variance between ordered and recalculated dose is this
What is 10%?
You must ensure these things are available and/or have been completed before administering chemotherapy
What is a spill kit, and emergency drugs?
Also will accept blood return, PPE, consent, correct tubing, route of administration, Pre-treatment EKG's, PDs or PK's
Wash the spill area from least contaminated to most contaminated using the Surface Safe product and following MIFU.
Then rinse twice with clean water
You are administering doxorubicin and notice an extravasation. You can use which two antidotes?
What are topical DMSO and Dexrazoxane?
This chemo requires documentation that the patient has a titanium port.
What is M7824?