Nursing 211

N211: Health Differences Across the Lifespan I of 148 Include monitor renal function, WBC, platelets and urine pH. Client may complain of pain at IV site, unless central IV. When taking Cisplatin assess for dizziness, tinnitus, hearing loss, tingling of hands and feet and hemorrhagic cystitis. Instruct client to report sore throat, signs and symptoms of infection and to use a low purine diet to alkalize urine. Alkylating drugs work by killing cancer cells by directly attacking DNA, the genetic material of the gene. Antitumor antibiotics interfere with DNA and RNA synthesis. Side effects include skin rashes, pulmonary fibrosis, allergic reaction, stomatitis, alopecia, nausea and vomiting. Drugs are Bleomycin, Actinomycin, Cerubidine, Valstar, Adriamycin and Nipent. Nursing Interventions include monitor CBC, WBC, platelets, bleeding time and electrolytes. When taking Adriamycin assess for signs of CHF. When taking Bleomycin assess for pulmonary toxicity. Instruct client to avoid using ASA or anti-coagulants. Plant Alkaloids prevent mitosis and cell division. Side effects include myelosuppression, neuropathy, leucopenia, ptosis, nausea, vomiting and alopecia. Drugs are Vinblastine, Vincristine, Taxotere and Navelbine. Nursing Interventions include assessment of CBC, WBC, platelets and uric acid. Vincristine is neurotoxic. Instruct client to report numbness and tingling, hoarseness and ataxia. Hormonal Enzymes block hormonal balance to slow growth rate of certain tumors; suppress the immune system. Side effects depend on the tumor type and suppression of the hormone type. Drugs are Estrogens, Progestins, Antiestrogens, Androgens and Antiandrogens Nursing interventions include monitoring for impotence, alterations in blood sugar, oral hypoglycemia and anticoagulant levels. Tamoxifen (Nolvadex) may cause edema and high calcium levels. When taking asparaginase monitor for pancreatic acid and uric acid levels. Instruct client to report decreased sexual response and swollen ankles. Additional side effects for men taking androgens is blistering of skin under patch (especially when the patch is applied to bony areas of the skin); breast soreness or enlargement; frequent or continuing erection of penis lasting up to 4 hours or painful penile erections lasting longer than 4 hours Side effects of Progesterone is excessive worrying. Immunomodulators or biological response modulators stimulate the immune system to detect and destroy cancer cells; they slow down tumor cell division. Side effects are chills, fever, myalgia, GI mild upset. Drugs are Interferon alfa-2a, alfa-2b and alfa-n3, Ergamisol and Interleukin-2. ©2012 Achieve Page 121