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ONS ONCC CHEMO RENEWAL II Exam
| Questions & 100% Correct Answers
(Verified) | Latest Update | Grade A+
Key Points for Combination Therapy Correct Answer: Oncology Nurses must consider Consider the potential toxicity related to each drug. Understand the monitoring guidelines for each drug. Have knowledge of clinically significant signs and symptoms ONS Evidence-Based Practice Resources Correct Answer: Evidence-based practice can have positive effects, such as: Improved patient outcomes Increased nurse satisfaction Potential cost savings Risk Factors For Colon Cancer Correct Answer: Increased age is a risk factor for developing colorectal cancer. The chance of developing colorectal cancer increases markedly after age 50. Roughly 9 out of 10 people diagnosed with colorectal cancer are at least 50 years old. Smoking,
alcohol intake, and a personal history of polyps are all things that increase risk. Other risk factors for the development of colorectal cancer include: Racial and ethnic backgrounds (African Americans and Jews of Eastern European descent [Ashkenazi Jews] have highest incidence) Diet high in red and processed meats Physical inactivity, obesity Type 2 diabetes Family history of colon cancer or inflammatory bowel disease Inherited familial syndromes (FAP, HNPCC) Patient Education on Chemotherapy Correct Answer: Patients are provided with verbal and written or electronic information as part of an education process before the first administration of treatment of each treatment plan. The content of this educational material will be documented. Educational information includes the following at a minimum: Patient's diagnosis Goals of treatment; that is, cure disease, prolong life, or reduce symptoms Planned duration of treatment, schedule of treatment administration, drug names and supportive medications, drug-drug and drug-food interactions, and plan for missed doses
also provided written information regarding his chemotherapy regimen to review at home. Mr. Patterson's treatment plan with FOLFOX6 consists of the following: Oxaliplatin 100 mg/m2 and Leucovorin 400 mg/m2 IV over two hours, then 5 - fluorouracil (5-FU) 400 mg/m2 IV bolus, followed by 5 - FU 3,000 mg/m2 IV by continuous infusion over 46 hours You have a long discussion with Mr. Patterson about his chemotherapy regimen, including his need for a port placement for IV access since he will be receiving 5-FU by continuous infusion for 46 hours. You discuss each agent in detail with Mr. Patterson, including the potential side effects of the agents he will receive. Your teaching highlights self-management strategies for these toxicities as well as when and how to reach someone from the office at any time of day. Which of the following is a unique side effect that occurs with the agent oxaliplatin? Correct Answer:. Cold sensory neuropathy Cold Sensory Neuropathy Correct Answer: Per the prescribing information for oxaliplatin, "the cold sensory neuropathy is an acute, reversible, primarily peripheral, sensory neuropathy of early onset (occurring within hours or one to two days of dosing) which resolves within 14 days, but frequently recurs with further dosing." The symptoms may be precipitated or exacerbated by exposure to cold temperature or cold objects. They usually present as transient paresthesia, dysesthesia, and hypoesthesia in the hands, feet, perioral area,
or throat. Jaw spasm, abnormal tongue sensation, dysarthria, eye pain, and a feeling of chest pressure have also been observed. Exposure to cold can cause very painful sensations following oxaliplatin therapy. Mr. Patterson is encouraged to avoid cold temperatures during the days following chemotherapy. Resolution of this side effect usually occurs within five days following therapy, but may last longer (Sanofi-Aventis, 2014). peripheral neuropathy Correct Answer: disorder of the peripheral nerves that carry information to and from the brain and spinal cord folfox 6 side effects Correct Answer: You discuss many other side effects of the agents (oxaliplatin, leucovorin, and 5-FU) that Mr. Patterson will receive. You cover the following common side effects of this chemotherapy regimen: peripheral neuropathy, myelosuppression, N/V/D, fatigue, fever, mucositis, alopecia, anorexia, and photosensitivity. You provide Mr. Patterson written handouts that review this same information. ONS PEP resources include evidence-based information on some of these side effects: Peripheral Neuropathy Prevention of Infection CINV
Discontinuing infusions of HDs Disposing of HDs and items contaminated by HDs Handling the body fluids of a patient who had received HDs in the past 48 hours Cleaning HD spills Touching any surface that is potentially contaminated with HD residue Colorectal Cancer Incidence Increasing in Young Adults Correct Answer: Colorectal cancer (CRC) incidence rates have been declining in the United States for several decades, most likely due to increased screening practices. Some studies, however, are showing an increase in CRC in the younger population (those younger than 50 years old) where routine screening is currently not recommended. Siegel et al. (2017) conducted a retrospective cohort study to characterize trends in population-based CRC occurrence by tumor location, age at diagnosis, and year of birth using incidence data from 1974-2013. This study found: Colon Cancer Late 1970s and early 1980s, colon cancer incidence rates were declining in age groups younger than age 50 years and increasing in those age 50 years and older From the mid-1980s until 2013, rates declined in adults age 55 years and older but increased in those younger than 50 years old, with most colon cancers occurring in the distal colon. Rectal Cancer
Incidence trends for rectal cancer are more prolonged for all age groups and the rise in young adults is steeper than compared with colon cancer. The proportion of rectal cancer diagnosed in adults younger than age 55 years years has doubled in just two decades Why the increase in incidence in young adults? The rise in CRC in young adults is likely fueled by increases in cumulative exposure to excess body fat. The obesity epidemic parallels the rise in CRC because many behaviors thought to drive weight gain, such as unhealthy dietary patterns and sedentary lifestyles, also increase CRC risk. What should be done? Adherence to recommended guidelines for initiation of screening should be emphasized and initiation of screening before the age of 50 years should be reconsidered. More research needs to be conducted; however, work needs to be focused on ways to curb the obesity epidemic and shift Americans toward healthier ea
