Patient Assessment & Monitoring Flashcards

Before starting chemotherapy, which baseline assessment is most critical?

Answer: Complete blood count (CBC)

A Complete Blood Count (CBC) is the most critical baseline assessment before chemotherapy because many chemotherapy drugs are myelosuppressive, meaning they can suppress bone marrow function. This assessment provides vital information about the patient's white blood cells, red blood cells, and platelets, which helps determine if the patient can safely receive treatment and guides dose adjustments.

Which symptom requires immediate attention during chemotherapy infusion?

Answer: Shortness of breath

Shortness of breath during chemotherapy infusion can indicate a serious adverse reaction, such as an allergic reaction, pulmonary toxicity, or fluid overload, which requires immediate medical intervention. While fatigue, mild nausea, and loss of appetite are common side effects, shortness of breath signals a potentially life-threatening emergency that demands prompt assessment and action.

What should be closely monitored in a patient receiving high-dose methotrexate?

Answer: Renal function

High-dose methotrexate is primarily excreted by the kidneys, making renal function monitoring absolutely critical to prevent severe toxicity. Impaired kidney function can lead to delayed drug clearance, resulting in dangerously high methotrexate levels. These elevated levels can cause severe myelosuppression, mucositis, and liver damage, necessitating careful monitoring.

A patient on chemotherapy reports a fever of 101.5°F. What should the nurse do first?

Answer: Notify the healthcare provider

A fever in a chemotherapy patient, especially one over 100.4°F (38°C), is a medical emergency and should be treated as neutropenic fever until proven otherwise. The nurse's first action must be to notify the healthcare provider immediately. Prompt evaluation and initiation of broad-spectrum antibiotics are crucial to prevent life-threatening sepsis in these immunocompromised patients.

Which lab value is most concerning in a chemotherapy patient?

Answer: Absolute neutrophil count (ANC) of 400

An Absolute Neutrophil Count (ANC) of 400 (or 0.4 x 10^9/L) indicates severe neutropenia, a critical side effect of chemotherapy that significantly compromises the patient's immune system. This level puts the patient at extreme risk for serious, life-threatening infections. It requires immediate medical attention and protective measures to prevent complications.

Why is regular oral assessment important during chemotherapy?

Answer: To detect signs of mucositis

Regular oral assessment is crucial during chemotherapy because many agents cause mucositis, an inflammation and ulceration of the mucous membranes lining the digestive tract, including the mouth. Early detection allows for timely interventions to manage pain, prevent infection, and maintain nutritional intake. This significantly improves patient comfort and outcomes.