Chemotherapy

Definition

Chemotherapy is the systemic use of cytotoxic drugs to kill rapidly dividing cancer cells. It is also effective against rapidly dividing normal cells (bone marrow, GI mucosa, hair follicles), producing characteristic side effects.

Common Side Effects

• Myelosuppression: anemia, neutropenia, thrombocytopenia
• Alopecia
• Nausea, vomiting, mucositis, diarrhea
• Fatigue
• Fertility changes
• Peripheral neuropathy

Neutropenic Precautions

Private room, strict hand hygiene, avoid fresh flowers/raw fruits and vegetables, no live vaccines, monitor temperature, daily CBC. Fever greater than 100.4°F (38°C) is a neutropenic emergency.

Safe Handling

Wear double chemotherapy-certified gloves, gown, and eye protection. Dispose of body fluids per hazardous waste protocol for 48 hours post-administration. Use closed-system transfer devices.

Nursing Interventions

Administer anti-emetics (ondansetron, dexamethasone) prophylactically. Provide oral care with soft toothbrush and non-alcohol rinse. Monitor labs closely. Teach patients to report fever, bleeding, and signs of infection immediately.

NCLEX Relevance

Neutropenic precautions and fever as emergency are high-yield topics.