32 Nursing Management of common side effects of Chemotherapeutic drugs. .

32

33 Nausea & Vomiting –. Nausea may cause the desire to vomit & it often precedes or accompanies
vomiting.

34 Eat frequent, small meals.

Avoid eating/drinking for 1-2 hrs prior to and after chemotherapy administrationEat frequent, small
meals.Avoid greasy & fatty foods and very sweet foods & candies.Avoid unpleasant sights, odors &
testes Follow a clear liquid dietIf vomiting is severe inform the physician.34

35 Administer antiemetic to prevent or minimize nausea.

Sip liquids slowly or suck ice cubes and avoid drinking a large volume of water if vomiting is
presentAdminister antiemetic to prevent or minimize nausea.Patient may require routine antiemetic for
3-5 days following some protocols.Monitor fluid and electrolyte status.Provide frequent, systemic
mouth care.35

36 .Bone marrow Depression – This can lead to -Anaemia -Bleeding due to thrombocytopenia -Infection
due to leukopenia 36

37 Nursing ActionsAdminister packed RBC according to the doctore’s order orders.Monitor hematocrit
and hemoglobinMaintain the integrity of the skin

38 Avoid activities with the greatest potential for physical injury

Use an electric razor when shavingAvoid the use of tourniquets Eat a soft, bland diet, avoid foods that
are thermally, mechanically and chemically irritating.Maintain the integrity of the mucous membranes
of GI tractPromote hydrate to avoid constipation38

39 Avoid enemas, harsh laxatives & the use of rectal thermometers.

Take steroids with an antacid or milk.Avoid sources of infectionMaintain good personal hygiene. Prevent
trauma to skin & mucous membranes Avoid invasive procedures, no ……

40 Alopecia Explain hair loss is temporary, and hair will grow when drug is stopped.
Use a mild, protein based shampoo, hair conditioner every 4-7 daysMinimize the use of an electric
dyer.Avoid excessive brushing and combing of the air.Combing with a wide –tooth comb is preferred.40

41 Select wig, cap, scarf or turban before hair loss occurs.

Keep head covered in summer to prevent sunburn and in winter to prevent heat loss.

42 Fatigue –Assess for possible causes chronic pain, stress, depression and in-sufficient rest or
nutritional intake.-Conserve energy & rest when tired-Plan for gradual accommodation of activities.-
Monitor dietary & fluid intake daily. Drink 3000 ml of fluid daily, unless contra-indicated, in order to
avoid the accumulation of cellular waste products.42
43 Anorexia Freshen up before meals
Avoid drinking fluids with meals to prevent feeling of fullnessHigh protein dietMonitor and record
weight weekly. Report weight loss

44 Stomatitis (Oral) – -Symptoms occur 5-7 days after chemotherapy & persist upto 10 days
-Continue brushing regularly with soft tooth brush-Use non irritant mouthwash-Avoid irritants to the
mouth-Maintain good nutritional intake, eat soft or liquid foods high in protein44

45 -Follow prescribed medication schedule e.g. drug for oral candidacies.

-Report physician if symptom persists-Increase the frequency of oral hygiene every 2 hrs-Glycerin &
lemon juice should never be used to clear mouth or teeth as it cause the tissues to become dry&
irritated.45

46 Diarrhoea- Some clients experience diarrhoea during and after treatment with
chemotherapy.Nursing Action – Monitor number, frequency and consistency of diarrhoea stools.46

47 Avoid eating greasy and spicy food alcoholic beverages, tobacco and caffeine products
Avoid using milk productsEat low residue diet high in protein and calories

48 Include food high in potassium if fatigue is present like bananas, baked potatoes.
Drink 3000 ml of fluid each day.Eat small frequent meals ; eat slowly and chew all food
thoroughlyAdminister anti-diarrhoeal agents as prescribed.48

49 Depression -Assess for changes in mood and affect

- small goals that are achievable daily Participatee.g. music, reading, outings Share feelings
Reassurance49

50 Cystitis- -An inflammation of the bladder,

-usually caused by an infection.-Sterile cystitis not induced by infection, can be a side effect of radiation
therapy or due to cyclophosphamide (endoxan) administration.-The metabolites of cyclophosphamide
are excreted by the kidneys in the urine50

51 -Fluid intake at least 3000 ml daily

Nursing Actions-Fluid intake at least 3000 ml daily-Empty Bladder as soon as the urge to void is
experienced.-Empty bladder at least every 2-4 hrs.-Urinate at bed time to avoid prolonged exposure of
the bladder wall to the effects of cytoxan while sleeping.51

52 Take oral cytoxan early in the morning to decrease the drug concentration in the bladder during the
nightReport symptoms of frequency bleeding burning on urination, pain fever and chills promptly to
physicianFollowing comfort measures can be adopted if cystitis is present Ensure dilute urine by
increasing the fluid intake- Avoid foods & beverages that may cause irritation to the bladder – alcohol,
coffee, strong tea, Carbonated beverages etc.52

53 Outpatient Chemotherapy Delivery Aggressive, complex and sophisticated cancer therapies are
currently being in ambulatory & home care settings. . 53
54 AdvantagesThis shift is provision of services from the Hospital setting is a result of cost-containment
efforts, advanced technology, competition & increased competence of nurses

55 Conclusion– Chemotherapy offers patients with cancer a great deal of hope for a cure or a means of
control cancer for a long period of time. Hope and optimism are vital ingredients in care plan.