A patient who has breast cancer tells the nurse that a cousin who ...

[evelyn o bentley]

A patient who has breast cancer tells the nurse that a cousin who had breast cancer received trastuzamab (Herceptin) and wonders why this drug is not given to her. The nurse will explain that her cancer cells do not have
 
  a. significant HER2 receptors.
  b. epidermal growth factor receptor-tyrosine kinase.
  c. the BRCA1 suppressor gene.
  d. VGEF proteins.

Question 2

The nurse is caring for a patient who is receiving vincristine (Oncovin), a plant alkaloid chemotherapeutic agent, to treat non-Hodgkin's lymphoma. The nurse observes that the patient has difficulty walking.
 
  What action will the nurse take?
  a. Ask about numbness or tingling in the fingers and toes.
  b. Assess heart rate and blood pressure to evaluate for orthostatic hypotension.
  c. Assess the temperature to evaluate for infection.
  d. Request an order for a complete blood count and electrolytes.

[kishoreddi]

Answer to Question 1

ANS: A
Trastuzamab acts by binding to the HER2 protein on the surface of cancer cells that overexpress this receptor. If patients do not have this overexpression, this targeted therapy will not work. Gefitinib is used when EGFR-TK are present. Bevacizumab is used when VGEF proteins are present.

Answer to Question 2

ANS: A
Peripheral neuropathy can occur with this drug and is manifested by difficulty walking and numbness and tingling in the fingers and toes. Orthostatic hypotension is not a side effect. Infection is always a concern, and regular evaluation of complete blood count and electrolytes is performed but not related to signs of peripheral neuropathy.

[evelyn o bentley]

Excellent

[atrochim]

TYSM