KRISHNA INSTITUTE OF NURSING SCIENCE, KARAD

PRACTICE TEACHING-8

SUBJECT :Medical-Surgical Nursing.

TOPIC :CHEMOTHERPY
YEAR :2ND YEAR RGNM
VENUE :K.H.KARAD
DATE :31/5/2017
TIME :2PM-4PM

SUBMITTED TO, SUBMITTED BY,

Mrs. Sushma mam. Mr. Nare chandrashekhar i.
Msc nursing lectural 1st year msc nursing,
Kins, karad Kins,karad
NAME OF STUDENT TEACHER:NARE CHANDRASHEKHAR I.
SUBJECT : Medical-Surgical Nursing.
TOPIC :CHEMOTHERPY
GROUP : 2ND YEAR RGNM
VENUE : K.H.KARAD
DATE :31/7/2017
TIME :2PM-4PM
A.V.AIDS :DEMONSTRATION

MEDIUM OF TEACHING : English, Marathi

GENERAL OBJECTIVES:
At the end of this procedure the nursing student will be able to understand the chemotherpy.

SPECIFIC OBJECTIVES:
At the end of this procedure the nursing student will be able to:
1. Define chemotherpy.
2. Explain the sign and symptoms of chemotherpy and causes of chemotherpy.
3. describe the chemotherpy
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SELF INTRODUCTION:
Hello, I am Nare Chandrashekhar irappa, 1st year M.sc. Nursing
today I am going to present the nursing procedure
chemotherpy.

CHEMOTHERPY:
Chemotherapy is an aggressive drug treatment that reduces
rapidly growing cells such as cancer cells.

Sign and symptoms of Chemotherapy:

Chemotherapy is designed to kill cells that divide quickly.

While cancer cells are these kinds of cells, other cells in your
body divide quickly as well. Cells in the following areas can be
adversely affected:

blood
hair
skin
lining of your intestinal tract

Because of this, the side effects of chemotherapy include:

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easy bruising and excessive bleeding
diarrhea
dry mouth
mouth sores
fatigue
a fever
hair loss
a loss of appetite
nausea
vomiting
weight loss
pain from nerve damage
infections
anemia
constipation
neuropathy
lymphedema
memory problems
concentration problems
skin changes
nail changes
insomnia
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sexual changes
fertility changes

Most side effects of chemotherapy subside when treatment is

over. Theres the risk of long-lasting effects that may develop
even years after the treatment, depending on the type of
chemotherapy used.

Complication These effects could include damage to

the:

heart
kidneys
lungs
nerves
reproductive organs
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DRUGS:

Drugs
Cyclophosphamide, methotrexate, 5-fluorouracil
Doxorubicin, cyclophosphamide
Mustine, vincristine, procarbazine, prednisolone
Doxorubicin, bleomycin, vinblastine, dacarbazine
Cyclophosphamide, doxorubicin, vincristine, prednisolone
Bleomycin, etoposide, cisplatin
Epirubicin, cisplatin, 5-fluorouracil
Epirubicin, cisplatin, capecitabine
Methotrexate, vincristine, doxorubicin, cisplatin
Cyclophosphamide, doxorubicin, vincristine,

Chemo drugs can be given in a variety of ways, depending on

the type of cancer you have and the chemotherapy drugs used.

Most often chemotherapy is given by injection into a vein. This

is known as intravenous chemotherapy.

Some drugs are given as tablets or capsules (oral

chemotherapy).

Some are injected into a muscle (intramuscular

injection).

Others may be injected just under the skin

(subcutaneous injection).
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INTRAVENOUS CHEMOTHERPY:
There are four ways of giving chemotherapy drugs directly into
the vein. These are through a:

Canula a small tube inserted into a vein in your arm or

the back of your hand.

Central line a thin, flexible tube inserted through the

skin of the chest into a vein near the heart.

PICC line (a peripherally inserted central catheter) a

thin, flexible tube passed into a vein in the bend or
upper part of the arm and threaded through until the end
of the tube lies in a vein near the heart.

Implantable port (also called a portacath) a thin, soft

plastic tube that is put into a vein. It has an opening
(port) just under the skin on your chest or arm.
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ORAL CHEMOTHERPY:

You may be given chemotherapy tablets or capsules to

take at home. Youll be told when to take them and will
be given other instructions such as whether or not to
take them with food. If you cant take your medicines
for any reason you should contact your doctor
immediately for advice.

It is important to take the drugs given to you by the

hospital exactly as they have been prescribed. Always
read the labels on the boxes before you leave the
hospital if the instructions are unclear, ask your nurse,
doctor or pharmacist.

INTRAVENTRICULAR CHEMOTHERPY:

Intraventricular or intrathecal chemotherapy is used when drugs

need to reach the cerebrospinal fluid in the brain and spinal cord
(CSF). There are two ways chemotherapy can be given to the
CSF:

Lumbar puncture (Intrathecal) Chemotherapy can be

given through a lumbar puncture (also called a spinal
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tap). In this case a small amount of chemotherapy is
injected during the lumbar puncture, directly into the
CSF.

Ommaya reservoir (Intraventricular) The ommaya

reservoir is a small, dome-shaped device with an
attached catheter. It is placed into the subcutaneous
tissue (the layer of tissue between the skin and the
muscle) on the scalp. The catheter is threaded into the
lateral (outer) ventricle of the brain.

A nurse or doctor, who is specially trained in this method of

giving chemotherapy, will insert a small needle through the skin
on the scalp into the ommaya reservoir to inject the
chemotherapy. This procedure is used most commonly in acute
leukaemias but can be used in other situations as well.

NURSING MANAGEMENT:

A. Bone marrow suppression leads to:

1. Decreased WBC count (immunosuppression).

Avoid crowds; people with infections and small children

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when WBC count is low
Consume a low-bacteria diet. Avoid overcooked meat
and raw fruits and vegetables

2. Decreased platelet count (thrombocytopenia)

When shaving use ellectirc razon only

Avoid contact sports and other activities that may cause
trauma
If trauma does occur, apply ice to the area and seek
medical assistance
Avoid dental work or other invasive procedures
Avoid aspirin and aspirtin-containing products

3. Decrease hemoglobin and hematocrit (anemia).

B. Gastrointestinal effcts : anorexia, nausea, vomiting, and

diarrhea
1. Client education for mainting adequate nutrition , and fluid
and electrolyte balance

Eat frequent, small, low-fat meals

Avoid spicy and fatty foods
Avoid extremely hot foods
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Nursing management of inadequate nutrition and fluit and
elctrolyte imbalances

Administer antiemetics prior to chemotherapy

Weigh client routinely and monitor for weight loss

C. Stomatitis (infammation of the mouth) and mucositosis

1. Client education for stomatitis and mucositosis

Use a soft toothbrush. Mouth swabs may be needed

during an acute episode
Avoid mouthwashes containing alcohol. do not use
lemon glycerin swabs or dental floss
Consider using chlorhexidine mouthwash (Peridex) to
decrease risk of hemorrhage and protect gums from
trauma
For Xerostomia, apply lubricating and moisturizing
agents to protect the mucopus membranes from trauma
and infection
Consicder using artificial saliva and hard candy or
mints to help with dryness of the mouth
Avoid smoking and alcohol, which can further irritate
the oral mucosa
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BIBLIOGRAPY:
Gullatte, M. M. (Ed.). (2014). Clinical guide to
antineoplastic therapy: A chemotherapy handbook.
Pittsburgh, PA: Oncology Nursing Society.
Polovich, M., Olsen, M., & K. B. LeFebvre. (Eds.).
(2014). Chemotherapy and biotherapy guidelines and
recommendations for practice (4th ed.). Pittsburgh, PA:
Oncology Nursing Society.
Schulmeister, L. (2011). Extravasation management:
clinical update. Seminars in Oncology nursing, 27(1),
8290.
WWW.WIKIPEDIA.COM
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