Chemotherapy 1. Alkylating Agent 2. Anti-Metabolites 3. Anti-Tumor 4. Plant-Alkaloids 5. Hormones

Chemotherapy
1. Alkylating agent
2. Anti-metabolites
3. Anti-tumor
4. Plant-alkaloids
5. Hormones.
1. Alkylating agent:
a. Destroys the DNA of the cancer cells thereby preventing replication/metastasis.
b. Cancer cells are sensitive to cell damage.
c. Drugs:
i. “to” – Cytoxan
ii. “ni” – nitrogen mustard (mustargen)
1. DOC: Hodgkin’s Disease
2. Anti-metabolites
a. Substitute erroneous DNA (nangongopya “controls DNA of cancer cells”)
b. “Give me 5”
i. Me – Methotrexate: DOC: H-mole and ectopic pregnancy
ii. 5 – 5FU(Fluorouracil) DOC: Colon and Lung cancer
3. Anti-tumor
a. Alters the DNA of cancer cell thereby prevents replication.
b. “Forget my sin”
i. Bleomycin
1. : complication = bleeding, baga (Pulmo toxic; o2 status)
ii. Adriamycin
1. Complication = alopecia, diarrhea, arrhythmia, red-orange urine
4. Plant – alkaloids = Plant – poison
i. Vinca – alkaloids
1. Oncovin
2. Vinplastin
3. Vinblastin
4. Vincrystin
5. Corticosteroids = anti- inflammatory
i. SE: immunosuppression
1. Prednisone
2. Dexamethasone
3. Betamethasone
4. Hydrocortisone
6. Hormones
a. Artificial hormone for cancer cells to prevent replication
i. estrogen promotes cancer (cancer eats estrogen promoting replication)
ii. progesterone prevents cancer
b. Tamoxifen (Niovaldex) = DOC: Breast cancer
c. Lupron
i. DES (Diethylstilbestrol) DOC: prostate cancer
ii. (Estrogen preparation) SE: Gynecomastia
Complications of Radiation/Chemotherapy
1.Bone marrow depression (Aplastic Anemia)
> decreased bone marrow activity (Pancytopenia)
> RBC = decreased (Anemia) (RBC = N 4.5 – 6.5 million)
>Fatigue
>Dyspnea
>Pallor
> WBC = decreased (Leukopenia) (WBC = N 5,000 – 10,000 count)
>Prone to Infection
> Platelets = decreased (Thrombocytopenia) (Platelent = 150,000 – 450,000 count)
>Bleeding
> Needs Reverse Isolation
>Process foods: pwede; Raw: di pwede
> Soft bristle
> electric razor
2. Sterility (Radiation Therapy)
> Female = Oophorexy > lift the ovary to prevent sterilization
> Male = Sperm Banking
3. Skin
> Radiation > Chemotherapy
> Dermatitis > Extravasation

(Burning of vessels)
> redness
> Swelling
> Burning
>Discontinue and change IV Site
> Apply cold compress
> Report/Refer
4. N&V = Most common SE of Chemotherapy (Cytoxan)
> administered before meals or with empty stomach. ( 30 minutes – 1 hr.)
> administer anti – emetics (Plasil) = 30 mins – 1hr prior to chemotherapy
5. Mouth
> Stomatitis “singaw” (Canker Sores)
> avoid alcohol-based products
> Gurgle with warm saline ( warm H20 + pinch of salt)
> Dryness of the mouth
> Ice – cold fluids (popsicle, ice-cream, etc)
6. Dryness of Vagina
> avoid alcohol-based products
> dapat water-based (KY Jelly)
7. Alopecia
> wear the wig before chemotherapy
> Comb the hair only 3x a week
GI Polyps = Increased risk to develop colon cancer
 Methotrexate = complication: decreased folic acid ( Vit. B9)

 Neural tube defect
Emergency & Disaster Nursing
Emergency = Medical condition that requires immediate intervention.
“Unang Yakap” (First Aid) = Acts as a stopgap before help arrives.
 Fracture = discontinuity of the bone

o Common Cause: Trauma = 90%
o Disease = 10%
 Signs of Fracture:
o PA: Pain r/t movement (Sharp pain)
o PI: CREPITUS (GRATING SOUND)
o IN: Inflammation
o DE: Deformity
*Most important/significant to assess is the type of bone
> Type of bone (Long bone = yellow marrow = fats)
Life-threatening complication of fracture:
1. Fat Embolism
Manifestations:
1. Dyspnea
2. Pulmonary Embolism
2. Pleuritic Chest Pain
Plan of Care:
1. Priority: Immobilize (Apply Splint)
2. O2 administration (Due to dyspnea)
3. Check pulse below affected area (Distal)
Confirmatory: X-ray
Care of Unconscious:
1. Survey the scene. (Safety)

Tap the Shoulder
2. Check for responsiveness
“Hey hey are you ok?”
Raise Hands
3. Call for help
Scream “Help”
A = Different Patient C = Solo
B A
C B
C – Circulation = Check for the pulse
 Infant – brachial pulse

 Child
Carotid Pulse
 Adult
Assessment:
#1 (-) Pulse = start CPR = Indicates Cardiac Arrest

#2 (+) Pulse = indicates presence of circulation
Head - tilt
A – airway
Chin – lift maneuver
 Give 2 Blows
B – Breathing (Lung Expansion)

 Look for rise and fall of the chest
 Listen for breath sound
 Feel for the rushing of air
(+) Pulse Indicates Respiratory Arrest = Rescue Breathing

(-) Breathing
Assessment
#1 (-) Pulse = Cardiac arrest = CPR
#2 (+) Pulse
Respiratory Arrest Rescue Breathing
(-) Breathing
#3 (+) Pulse
Pt has revived Recovery Position
(+) Breathing
(Side lying)
CPR = Indicated cardiac arrest

Universal Ratio: 30:2 = 5 cycles (100 – 120 bpm)
= 30 compressions & 2 Blows ( Ventilation )
Infant Child Adult

2 Fingers 1 Hand 2 Hands
Interlocking w/ other
Depth of ½ - 1 inch 1 – 1 ½ inches 1 ½ - 2 (2.5) inches

Compression
When to stop CPR:

1. When Rescuer is Exhausted
2. When Help Arrives
3. When “DNR” (do not resuscitate) is advised
4. During Defibrillation (200 – 360 joules) make sure no one is touching the patient.
5. When proclaimed Dead
Triage
Triage = to prioritize/sort out
Goal: Do the greatest good for the greatest # of people

Principle: Utilitarianism
Leadership: Autocratic
Priority: (Highest)
1. RED (Emergent)
= Life threatening but with minimum intervention
= Airway = Breathing = Circulation = Increased ICP (Disoriented/Confused) Spinal Cord
Injury
2. Yellow (Urgent)
= Serious but not life – threatening
o Fracture
o Crash Injury
3. Green (Non-urgent)(Delayed)
= Survival is good even with minimum intervention
= can wait for hours or days
o Ambulatory
o Insect bites
o Emotional concerns
4. Black (Expectant)
= survival is unlikely even with intervention
o Needs CPR
o Arrest
o Dead

Chemotherapy 1. Alkylating Agent 2. Anti-Metabolites 3. Anti-Tumor 4. Plant-Alkaloids 5. Hormones

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Chemotherapy 1. Alkylating Agent 2. Anti-Metabolites 3. Anti-Tumor 4. Plant-Alkaloids 5. Hormones

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Chemotherapy

1.Bone marrow depression (Aplastic Anemia)

> decreased bone marrow activity (Pancytopenia)

> RBC = decreased (Anemia) (RBC = N 4.5 – 6.5 million)

> WBC = decreased (Leukopenia) (WBC = N 5,000 – 10,000 count)

> Platelets = decreased (Thrombocytopenia) (Platelent = 150,000 – 450,000 count)

> Needs Reverse Isolation

>Process foods: pwede; Raw: di pwede

> Soft bristle

> electric razor

2. Sterility (Radiation Therapy)

> Female = Oophorexy > lift the ovary to prevent sterilization

> Male = Sperm Banking

> Radiation > Chemotherapy

> Dermatitis > Extravasation

>Discontinue and change IV Site

> Apply cold compress

4. N&V = Most common SE of Chemotherapy (Cytoxan)

> administered before meals or with empty stomach. ( 30 minutes – 1 hr.)

> administer anti – emetics (Plasil) = 30 mins – 1hr prior to chemotherapy

> Stomatitis “singaw” (Canker Sores)

> avoid alcohol-based products

> Gurgle with warm saline ( warm H20 + pinch of salt)

> Dryness of the mouth

> Ice – cold fluids (popsicle, ice-cream, etc)

> avoid alcohol-based products

> dapat water-based (KY Jelly)

> wear the wig before chemotherapy

> Comb the hair only 3x a week

GI Polyps = Increased risk to develop colon cancer

 Methotrexate = complication: decreased folic acid ( Vit. B9)

Emergency = Medical condition that requires immediate intervention.

“Unang Yakap” (First Aid) = Acts as a stopgap before help arrives.

 Fracture = discontinuity of the bone

*Most important/significant to assess is the type of bone

> Type of bone (Long bone = yellow marrow = fats)

Life-threatening complication of fracture:

1. Survey the scene. (Safety)

A = Different Patient C = Solo

C – Circulation = Check for the pulse

 Infant – brachial pulse

#1 (-) Pulse = start CPR = Indicates Cardiac Arrest

B – Breathing (Lung Expansion)

(+) Pulse Indicates Respiratory Arrest = Rescue Breathing

CPR = Indicated cardiac arrest

Infant Child Adult

Depth of ½ - 1 inch 1 – 1 ½ inches 1 ½ - 2 (2.5) inches

When to stop CPR:

Goal: Do the greatest good for the greatest # of people

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