Chemotherapy Nursing Priorities for NCLEX
Chemo: side effects by class, extravasation, anti-emetics, neutropenia.
Chemo administration and complications. NCLEX tests common side effects and emergency management.
Common side effects
Myelosuppression (neutropenia, anemia, thrombocytopenia). N/V, pre-medicate. Alopecia. Mucositis, oral care. Fatigue.
Drug-specific toxicities
Doxorubicin, cardiomyopathy (lifetime dose limit). Cisplatin, nephrotoxicity, ototoxicity. Bleomycin, pulmonary fibrosis. Methotrexate, hepatotoxicity, mucositis (leucovorin rescue).
Extravasation
Stop infusion immediately. Don't remove IV, try to aspirate. Cold compress for most (warm for vinca alkaloids). Antidote per drug (e.g., dexrazoxane for anthracyclines).
Anti-emetics
Pre-medicate. Ondansetron + dexamethasone + aprepitant for high-emetic-risk regimens.
Frequently asked
Vesicant vs non-vesicant?
Vesicants cause tissue necrosis with extravasation (anthracyclines, vinca alkaloids). Use central line when possible.
Patient teaching for outpatient chemo?
Fever ≥38.3 call immediately. Hand hygiene. Avoid sick contacts. Take antiemetics on schedule first 2-3 days.
Quick check
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