A nurse is discussing the care of a patient with cancer with a ...

[saliriagwu]

A nurse is discussing the care of a patient with cancer with a nursing student. The patient is about to begin chemotherapy with a bifunctional alkylating agent.
 
  Which statement by the student indicates an understanding of this chemotherapeutic agent?
  a. Alkylating agents are toxic to tissues that have rapidly dividing cells.
  b. Bifunctional alkylating agents do not have the capacity to form cross-links in DNA.
  c. Resistance to alkylating agents is rare.
  d. This drug needs to be given as a prolonged infusion.

Question 2

A patient on an oncology unit has been receiving ifosfamide (Ifex) for a few days. Before administering the next dose, the nurse reviews the patient's laboratory test results. Which finding would cause the nurse to hold the dose?
 
  a. Elevated white blood cell count
  b. Low hemoglobin and hematocrit levels
  c. Low levels of ketones in the urine
  d. Microscopic hematuria

[Ahernandez18]

Answer to Question 1

ANS: A
Alkylating agents are toxic to rapidly dividing cells. Bifunctional agents form cross-links in cell DNA. Resistance to alkylating agents is common. These drugs may be given by bolus dosing.

Answer to Question 2

ANS: D
The nurse should hold the dose for microscopic hematuria, because this may indicate hemorrhagic cystitis. An elevated white blood cell count is not an indication to hold the dose. Low hemoglobin and hematocrit levels are expected for a patient undergoing chemotherapy. Ketones may reveal some other problem, but they are not associated with ifosfamide.