BSA
SAFETY is the key to be error free
WHO, WHAT, WHERE, WHEN?
RESCUE ME
MISCELLANEOUS - RECAP
100

Where do you find the patient's calculated BSA value in EPIC to confirm it is correct?

In the Storyboard

100

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. 

100

Empty chemotherapy bags, tubing, etc get disposed of in WHICH COLORED chemotherapy waste disposal bin? 

YELLOW disposal bin

100

Should emergency medications be released when you release the chemotherapy regimen for the day? 

No, only if a reaction occurs

100

After completing the pre-medications, is another set of vital signs and reassessment of the patient required before starting the chemotherapy regimen? 

Yes

200

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. 

200

Where does the RN go to verify consent in a pre-chemo checklist in EPIC?

Open the patient chart, then "Chart Review", then "Media"

200

Chemotherapy with residual solution gets disposed of in WHICH COLORED chemotherapy waste disposal bin?

BLACK disposal bin

200

What is the rescue medication when high doses of methotrexate is given?

Leucovorin

200

The instructions for cleaning a chemotherapy spill can be found on the Spill Kit box. 

True

300

What is the BSA of a patient who weighs 400kg and is 168cm tall?

BSA = 4.32

300

Before each chemotherapy/immunotherapy treatment, how many independent checks are done?

Two

300

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

300

Where do you document a possible Extravasation? (2)

1. LDA and nurse's note in EPIC

2. VERGE must be placed

300

If your patient complains of itchiness and shortness of breath during a blood transfusion, what is your PRIORITY nursing intervention?

Stop the infusion

400

What is the BSA of a patient whose weight is 65lbs and whose height is 40in tall?

BSA = 0.91

400

When are independent checks completed? (2)

1. During the BSA calculations

2. When the RN receives the chemotherapeutic agents

400

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

400

Who is notified of an Adverse Drug Reaction? (3)

1. Pharmacy

2. RN Manager or Supervisor

3. Physician

400

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

500

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

500

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      

500

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

500

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

500

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