Discuss the common complications (adverse effects) of chemotherapy

Case Study: Nicole is admitted to the pediatric unit of the local hospital with a temperature of 38.8º C (101.8º F) that did not respond to the acetaminophen that she has been taking every 4 hours since yesterday. Her admission assessment indicated that Nicole’s lung sounds are clear, heart sounds are strong and regular, she is in no apparent distress, has alopecia, and has evidence of white patches in her mouth. Her laboratory values include: Hematology: Hemoglobin: 10.1 g/dL Hematocrit: 25% Platelets: 50,000/mm3 White blood cell count: 2,000/mm3 Differential: Neutrophils 20%

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1. Discuss the significance of Nicole’s laboratory findings.

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2. What other assessment data would be helpful for the nurse to have to prepare I Nicole’s care plan?

3. What are the priorities of care for Nicole on admission?

4. Discuss the common complications (adverse effects) of chemotherapy.

5. What nursing actions address the adverse effects associated with chemotherapy?

6. Nicole is receiving cyclophosphamide intravenously. Discuss this agent including any nursing interventions necessary specifically related to its use. 7. Nicole is diagnosed with a CVAD line infection. Discuss how these infections occur and why.

8. Nicole’s mother is staying with Nicole during her hospitalization and expresses concern about Nicole refusing to see her friends and that Nicole seems “down” since her last chemotherapy. Discuss your impressions about Nicole’s mother’s statements, considering Nicole’s level of growth and development.

9. Nicole tells the nurse that her mouth and throat are so sore she cannot drink or eat anything. Discuss your impressions about Nicole’s complaints and the appropriate nursing actions to help Nicole.

10. Nicole is prescribed intravenous antibiotic therapy to treat her line infection. The health care provider prescribes gentamicin sulfate 100 mg IV q8h. vancomycin hydrochloride 500 mg IV every Case Studies Product Sampler Case Studies in Pediatrics CASE STU DY 5 NICOLE 6 hours, and cefoxitin sodium 1 g IV every 6 hours. Nicole weighs 40 kg (88 lb). Discuss these agents and if the doses prescribed are safe for Nicole.

11. The pharmacy schedules Nicole’s antibiotic therapy as follows: Gentamicin 2400h 0600h 1200h 1800h Vancomycin 0200h 0800h 1400h 2200h Cefoxitin 2400h 0600h 1200h 1800h Discuss this schedule and what alterations the nurse should make, if any.

12. Calculate the rates of administration via a volumetric intravenous infusion pump for the following: Gentamicin sulfate: 100 mg in 100 mL of 5% dextrose in water to infuse over 30 minutes Vancomycin hydrochloride: 500 mg in 250 mL of 0.9% normal saline Cefoxitin sodium :1 gin 50 mL of 5% dextrose in water to infuse over 15 minutes

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