OCC Supportive Care & Symptom Management Flashcards

Which intervention is MOST effective for managing cancer-related depression in oncology patients?

Answer: Combined pharmacotherapy (antidepressants) and psychotherapy (CBT or supportive counseling)

The combination of antidepressant pharmacotherapy with psychotherapy (especially CBT) has the strongest evidence for treating cancer-related depression.

A patient receiving chemotherapy reports moderate-to-severe cancer-related fatigue. Which assessment finding would indicate a potentially treatable contributing cause?

Answer: Hemoglobin of 7.5 g/dL with symptoms of dyspnea on exertion

Anemia (Hgb 7.5 g/dL) with symptomatic dyspnea is a directly treatable cause of cancer-related fatigue, warranting evaluation for RBC transfusion or erythropoiesis-stimulating agents.

Which sleep hygiene strategy has the STRONGEST evidence for managing insomnia in cancer patients?

Answer: Cognitive behavioral therapy for insomnia (CBT-I)

CBT-I is the first-line, evidence-based treatment for insomnia in cancer patients, with sustained benefits that outlast pharmacologic interventions.

A patient with advanced cancer and dyspnea at rest has oxygen saturation of 94% on room air. Which intervention is MOST evidence-based for managing refractory dyspnea?

Answer: Low-dose oral or IV opioids to reduce the sensation of breathlessness

Low-dose opioids are the most evidence-based pharmacologic intervention for refractory dyspnea in cancer patients, regardless of oxygen saturation.

A cancer patient receiving corticosteroids long-term for symptom management is at risk for which complication requiring prophylactic management?

Answer: Osteoporosis, hyperglycemia, and Pneumocystis jirovecii pneumonia (PCP)

Long-term corticosteroid use in cancer patients risks osteoporosis, steroid-induced hyperglycemia, immunosuppression, and PCP, often requiring prophylactic calcium/vitamin D, glucose monitoring, and TMP-SMX.

A hospice patient with cancer develops the death rattle (noisy breathing). What is the MOST appropriate nursing intervention?

Answer: Reposition the patient, explain the sound to family, and administer anticholinergic medications if ordered

The death rattle results from secretions the patient can no longer clear; repositioning helps drainage, family education reduces distress, and anticholinergics (glycopyrrolate/hyoscine) reduce secretion production.