How can central venous access devices (CVADs) be of value in a patient receiving chemotherapy who has stomatitis and severe diarrhea?
A. The chemotherapy can be rapidly completed allowing the stomatitis and diarrhea to resolve.
B. Crystalloid can be administered to prevent dehydration.
C. Concentrated hyperalimentation fluid can be administered through the CVAD.
D. The chemotherapy dose can be reduced.
Correct Answer: C. Concentrated hyperalimentation fluid can be administered through the CVAD.
For patients who are unable to take oral nutrition, a parenteral hyperalimentation is an option for providing nutritional support. High concentrations of dextrose, protein, minerals, vitamins and trace elements can be provided. Dosing is not affected in options a and d. Hyperalimentation can provide free water and considerable nutritional benefits.
Option A: The outcome and prognosis of patients with a CVAD directly depend on the complications. If complications are minimized, the outcome related to the placement of these lines is excellent. In addition, meticulous and sterile care of the CVAD can also prevent line infections.
Option B: Crystalloid can provide free water but has very little nutritional benefits. Crystalloid fluids are a subset of intravenous solutions that find frequent use in the clinical setting. Crystalloid fluids are the first-line choice for fluid resuscitation in the presence of hypovolemia, hemorrhage, sepsis, and dehydration. Further clinical applications include acting as a solution for intravenous medication delivery, delivering maintenance fluid in patients with limited or no enteral nutrition, blood pressure management, and increasing diuresis to avoid nephrotoxic drug or toxin-mediated end-organ damage.
Option D: There is a possibility that decreasing the dose would decrease the effectiveness of the drug, no matter what genotype a patient had. Chemotherapy is a type of treatment that targets and kills rapidly dividing cells, such as cancer, and is a hallmark of cancer treatment. Unfortunately, this type of medicine also kills rapidly dividing cells that are not cancerous, such as blood and skin cells and the lining of the intestine. This toxicity causes serious side effects, leaving patients ill and bedridden. Many patients are reluctant to start potent chemotherapy regimens, no matter how effective, because they are concerned about the toll the side effects will take on daily living.