Comprehensive Nursing Pharmacology Q 93

Correct Answer: C. Myelosuppression.

The overall goal of cancer chemotherapy is to give a dose large enough to be lethal to the cancer cells, but small enough to be tolerable for normal cells. Unfortunately, some normal cells are affected including the bone marrow. Myelosuppression limits the body’s ability to prevent and fight infection, produce platelets for clotting, and manufacture red blood cells for oxygen portage. Even though the effects in options a, b, and d are uncomfortable and distressing to the patient, they do not have the potential for lethal outcomes that myelosuppression has.

Option A: Drugs that travel through the body are more likely to cause nausea and vomiting than treatment that only affects one area of the body, such as radiation therapy. And, some drugs are more likely than others to cause nausea and vomiting. Acute nausea and vomiting usually happen within minutes to hours after treatment is given, and usually within the first 24 hours. This is more common when treatment is given by IV infusion or when taken by mouth.

Option B: If the client notices unusual bleeding, including blood in the urine, stool, vomit, or bleeding gums, notify the doctor. Easier bruising or longer bleeding time after a minor cut is normal. Red blood cells can also be affected by some chemotherapy drugs.

Option D: Oral mucositis results from a complex interaction of local tissue damage, the local oral environment, the patient’s level of myelosuppression, and the patient’s intrinsic genetic predisposition (eg, single nucleotide polymorphisms) to develop oral mucositis. A bland, soft diet is recommended. Patients should avoid acidic, spicy, salty, coarse, and dry foods. Patients should keep the mouth moist with frequent sips of water, ice chips, or popsicles. Patients with severe oral mucositis may require total parenteral nutrition.