Antineoplastic

Medications

Case Study

Hogan, Mary Ann, Pharmacology: Reviews

& Rationales, 1st Edition, 2001.

Electronically reproduced by permission of

Pearson Education, Inc.,

Upper Saddle River, New Jersey.

Case Study:

Antineoplastic

Medications

A 64-year-old male client is admitted for his

first dose of chemotherapy. His wife died

six months ago of a massive heart attack.

He has two daughters who live out of state;

one is a lawyer, while the other is a

pediatrician. The client is the chief

executive officer (CEO) of his own electronic

business, is self-insured, and has no

oncology supplement.

Chemotherapy orders

include:

Cytoxan 800 mg IVPB

Methotrexate 160 mg IVPB

Adriamycin 40 mg in 1000 ml. normal saline IV infusion over 24 hr times 2 doses

Leucovorin 75 mg IVPB Q 6 hrs times 4 doses; begin Leucovorin 24 hr after methotrexate

5-FU 80 mg IVPB after second dose of leucovorin

Other medication

orders include:

Zofran 35 mg IVPB prior to starting chemotherapy and prior to the second liter of Adriamycin

Zofran 15 mg IVPB 4 and 8 hr after each 35 mg loading dose

Benadryl 12.5 mg Reglan 5 mg, and Decadron 2 mg IVPB Q 6 hours around the clock

Diagnostic studies

include:

MUGA scan

Ultrasound of the liver

CBC

Chemistry profile

Questions:

1. What are the most important nursing

diagnoses, and what is your rationale for

prioritizing them the way you did?

2. What important diagnostic/assessment

values need to be obtained before

initiating the chemotherapy?

3. Outline a pre-treatment teaching plan for

this client.

Questions:

4. What orders need further clarification

with the physician?

5. How will you prepare the client for

discharge from the hospital?

To review

suggested

responses, please

click here.

Case Study Developed By

Susan Steele, DNS, RN, AOCN