Chapter 46, Problem 2CTPQ

Summary Introduction

To describe:

A patient has been taking bleomycin irrigations for three days through the chest tube. Today, the patient begins to have some health issues such as irregular and slow heart rhythm and nausea. He says, “I am seeing yellow hazy circles around the light.” The patient thinks that he is getting all these problems because of chemotherapy. The nurse reviews the medications of the patient and notes that the patient is taking other medications such as digoxin (Lanoxin), lisinopril (Zestril), and simvastatin (Zocor). What is the priority action of the nurse at this time?

Concept introduction:

Cancer cells are characterized by the uncontrolled proliferation of abnormal cells, invasion, metastasis, and anti-apoptosis. Chemotherapeutic drugs are broadly classified into two categories based on targeting the phases of the cell cycle (cell cycle specific drugs and cell cycle non-specific drugs). Alkylating drugs are cell-cycle nonspecific anticancer drugs. They are used to treat the wide range of cancers, including solid and hematological tumors. Alkylating drugs are commonly categorized into three, namely, classic alkylators (for example, chlorambucil, and cyclophosphamide), nitrosoureas (for example, carmustine and lomustine), and miscellaneous alkylators (for example, altretamine and busulfan). The alkylating drugs prevent cancer progression by inhibiting the DNA synthesis through the formation of covalent bonds with DNA bases. The major adverse effects of alkylating drugs are pulmonary fibrosis, nephrotoxicity, neurotoxicity, ototoxicity, and bone marrow suppression.