- Antineoplastic Agents
An older adult patient has recently been diagnosed with prostate and kidney cancer. The patient has a lot of concerns and questions about antineoplastic agents that he is going to be receiving following surgery 3 months ago.
What are the anticipated changes the patient’s body undergoing when cancer occurs?
The body of the patient is likely to go through changes such as unexplained weight loss especially for prostate cancer. The patient is also likely to have increased incidences of body fatigue and pain in the back, thighs, shoulders and bones. The patient might experience swelling on the feet and legs and fluid build-up. It might also result into changes in the bowel habits where the individual might have a frequent urge to urinate. Prostate cancer might lead to the onset of erectile dysfunction. A mass or lump around the abdomen occurs when a patient has kidney cancer. Blood in the urine might be another bodily change that the patient will experience (Maltser et al., 2017).
What is the goal of cancer chemotherapy?
The goal of chemotherapy is to eliminate the cancerous cells in the body while minimizing the negative effect it might have on the healthy cells in the human body. Chemotherapy prevents the cancer cells from growing or dividing into more cells. In some instances chemotherapy could be used to cure cancer.
Why are antineoplastic agents often given in combination?
The agents are given in a combination as they are more effective than single agents alone. Each agent has a way of targeting cancerous cells. The combination therefore decreases the likelihood of resistance of the cancer cells to the drugs.
What are the key points that the nurse needs to review with the patient receiving cancer-specific agents?
The nurse should consider the following when administering cancer-specific agents:
- Assessing for mentioned contradictions and cautions such as allergies to prevent further complications
- Perform through physical check up of the patient to establish relevant drug therapy
- Monitor laboratory results to identify effects of specific drugs on the patient
- Arrange for periodic blood tests after therapy to monitor the need for change in dosage or discontinuation of drug
- Ensure patients are well hydrated to prevent renal complications such as toxicity.
- Evaluate the patient’s understanding of the drug therapy and educate them as needed (Maltser et al., 2017)
The registered nurse is assigned to care for a pediatric client who is receiving immune suppressants. The registered nurse is precepting a student nurse. The registered nurse reviews the key nursing considerations that the student needs to consider in the care of this patient.
What are the therapeutic actions of an immune suppressant?
Immune depressants weaken the immune system and suppress then reaction of autoimmunity in the body. The autoimmune disease leads to the body attacking its tissues.
What are the key considerations of the use of immune modulators in children?
- The nurse should remember that most immune modulators are not recommended for children
- Very few immune depressants such as inferno alfa-2b could be used but with caution as they are toxic to the central nervous system, renal systems and GI in children
- Children under immune modulators should be protected from any form of injury or infection (Tabangcora, 2019)
What are the key teaching needs for a patient receiving an immune stimulant?
The patient should be taught on what the risk of exposure to injury or infections might have on their health. They should also be educated on proper techniques for administration of the stimulants and proper disposal of the materials afterwards. The patients should also be educated on the special storage precautions for the drug (Tabangcora, 2019).
- 3. Introduction to the Reproductive System
A school nurse is preparing a presentation on the reproductive system for a health class. The school nurse needs to review the effects of the sex hormones estrogen, progesterone, and testosterone.
What are the effects of estrogen?
Estrogen stimulates the female characteristics when a girl reaches puberty. They regulate the menstrual cycle thus controlling activities such as ovulation each month. Estrogen also stimulates the growth of the egg follicle and maintains the thickness of the vaginal walls to promote lubrication. It is also used by the body to form the breast tissues and is also the hormone that prevents prenatal milk from weaning.
What are the effects of progesterone?
The hormone prepares the endometrium for possible pregnancy when a lady goes through their ovulation cycle. It prevents the body from rejecting an egg through prohibiting any contractions in the uterus. In the male body, the hormone is the building block to many other hormones in the body such as testosterone. It helps in the building of body mass and regulates brain activity and functions of the body.
What are the effects of testosterone?
It is a sex hormone and regulates the sex drive in men. It is also has effects on the body such as bone mass, muscle mass, production or the red blood cells and sperms. In ladies, high levels of testosterone can cause deepening of the voice, enlarged clitoris, muscle mass and infertility (Margo & Winn, 2006).
What is the clinical presentation of each stage of the human sexual response?
The first stage is excitement where the body becomes aroused. The male and female sexual organs prepare for sexual activities such as becoming thick and well lubricated. The plateau phase is characterized by increased circulation of blood and increased heart rate as sexual pleasure and stimulation occurs. The orgasmic phase is the climax and body releases all the sexual tension. It involves the release of oxytocin from the pituitary gland causing muscular contractions. The last stage is the resolution phase which allows the muscles to relax and the body to go back to normal.
What are the changes that occur to the female body during pregnancy?
During pregnancy women bodies go through various changes such as expanding belly and weight gain, the uterus enlarges, the skin becomes smooth, and joints loosen during the pregnancy due to Relaxin hormones that soften ligaments. Many women also develop stretch marks as the skin is stretched during pregnancy. The marks occur on the buttocks, thighs and breasts and abdomen.
4.Drugs Affecting the Female Reproductive System
A nursing student is preparing information for clinical in a women’s health clinic. The faculty member has advised the nursing student to be familiar with common drugs that affect the female reproductive system, including estradiol and clomiphene (Clomid).
What are the therapeutic actions for estradiol?
It is used in the treatment of menopause symptoms in women. It is also prevents osteoporosis (bone loss) in women that have reached the age of menopause. The drug is also used to treat low estrogen levels in women that have ovarian failure.
What are the indications for clomiphene (Clomid)?
- The medication is an ovulatory stimulant
- Increase in production of gonadotropins
- It causes the ovaries to release one or more eggs (Tabangcora, 2019)
What are the lifespan considerations for adults with the use of drugs that affect the female reproductive system?
The use of reproductive drugs can increase the risk of cervical and breast cancer in the future life of the individual. Adults that use drugs that affect the reproductive system also have a likelihood of developing reproductive complications due to the side effects of the drugs (Tabangcora, 2019).
What is the nursing implementation considerations for patients receiving drugs used to affect the female reproductive system?
The first consideration is the assessment of the mentioned contradictions and cautions such as drug allergies, ovarian failures and adrenal dysfunction. The nurse should also assist with pelvic and breast examination. The specimen collected should be able to obtain the menstrual history of the patient to provide baseline data for the treatment. The nurse should assess the causes of dysfunction before beginning therapy. The nurse should also check the estrogen and estradiol levels before beginning therapy.
5.Drugs Affecting the Male Reproductive System
A nursing student is preparing information for clinical in a men’s health clinic. The faculty member has advised the nursing student to be familiar with common drugs that affect the male reproductive system, including testosterone (Duratest, Testoderm), oxandrolone (Oxandrin), and sildenafil (Revatio).
What are the therapeutic actions for testosterone (Duratest, Testoderm)?
- Treating low levels of natural testosterone produced in the body
- Remedying erectile dysfunction and low sex drives
- Enhancing physical performance through increase of muscle mass (Margo & Winn, 2006)
What are the indications for oxandrolone (Oxandrin)?
- Weight gain
- Delayed puberty in males
- Short stature in Turner’s syndrome
- Bone pain due to Osteoporosis
- Muscular dystrophy
What are the most common adverse effects for sildenafil (Revatio)?
Sildenafil has numerous adverse side effects. They include stomach upsets, flushing, dizziness and headaches. It also increases sensitivity to light and blurred vision.
What are the nursing implementation considerations for patients receiving drugs used to treat penile erectile dysfunction?
For patient receiving such drugs the nurse should consider any contradictions such as allergies that might cause a reaction to the ED drugs the patient receives. The nurse should also identify the main cause of the ED during the assessment before administering the drugs to the patient. The nurse should consider the how the lifestyle issues of the patient affects their condition. They should understand the knowledge the patient has about ED and teach the patient on best ways to dealing with ED inclusive of drug therapy.