OCC Supportive Care & Symptom Management Flashcards

A patient with cancer-related anorexia-cachexia syndrome asks if there are medications that can help with appetite. Which agent has FDA approval for this indication in cancer patients?

Answer: Megestrol acetate (Megace)

Megestrol acetate is FDA-approved for treating anorexia and cachexia in cancer patients and promotes appetite and weight gain through progesterone receptor activity.

Which patient population is at HIGHEST risk for developing oral mucositis during chemotherapy?

Answer: Patients receiving high-dose methotrexate, 5-FU, or those undergoing bone marrow transplant conditioning

High-dose antimetabolites (methotrexate, 5-FU) and myeloablative conditioning regimens for bone marrow transplant carry the highest risk of severe oral mucositis.

A patient with bone metastases and moderate pain (5/10) is on scheduled long-acting opioids. They ask what the breakthrough dose should be. What is the standard calculation?

Answer: The breakthrough dose is typically 10-15% of the total daily opioid dose, given every 1-4 hours as needed

Standard oncology pain management guidelines recommend breakthrough doses of 10-15% of the total daily opioid dose, available every 1-4 hours for episodic or breakthrough pain.

A patient with advanced cancer is being discharged with a PCA pump for home pain management. Which education point is MOST critical for caregiver safety?

Answer: Only the patient should press the PCA button; caregiver-controlled dosing increases overdose risk

PCA is designed for patient-only activation; caregiver- or nurse-activated dosing bypasses the safety feature that prevents dosing while the patient is sedated, risking respiratory depression.

Which assessment scale is MOST appropriate for evaluating pain in an oncology patient with moderate cognitive impairment?

Answer: PAINAD (Pain Assessment in Advanced Dementia) scale

The PAINAD scale assesses pain through behavioral indicators (breathing, vocalization, facial expression, body language, consolability) in patients who cannot self-report reliably.

A nurse is providing spiritual care to a Muslim patient with terminal cancer who is declining end-of-life medications due to religious concerns about sedation. What is the BEST approach?

Answer: Respect the patient's religious autonomy, involve a chaplain, and explore non-sedating symptom management alternatives

Respecting patient autonomy and religious beliefs requires an interdisciplinary approach including chaplaincy, while exploring non-sedating alternatives that align with the patient's values.