The client is prescribed tamoxifen for the treatment of breast ...

[dakota nelson]

The client is prescribed tamoxifen for the treatment of breast cancer. The nurse should advise the client to monitor for which adverse effect?
 
  1. Fatigue
  2. Cough
  3. Vaginal discharge
  4. Signs of dehydration

Question 2

The most important nursing consideration for clients receiving alkylating agents is
 
  1. monitoring nausea and vomiting.
  2. monitoring nutritional intake.
  3. monitoring skin integrity.
  4. monitoring CBC with differential.

[emsimon14]

Answer to Question 1

Correct Answer: 3
Rationale 1: Fatigue may occur with many types of chemotherapy, but is not a particular adverse effect with tamoxifen.
Rationale 2: Cough is not an expected adverse effect of tamoxifen.
Rationale 3: Vaginal discharge is an expected adverse effect of tamoxifen and should be reported to the health care team.
Rationale 4: Rather than dehydration, the client should be monitored for water retention and concentrated urine.

Answer to Question 2

Correct Answer: 4
Rationale 1: Nausea and vomiting are common during use of many chemotherapy drugs and are not particular to alkylating agents, and this is not the most important nursing consideration.
Rationale 2: Due to adverse effects such as nausea, vomiting, and anorexia, nutritional intake is decreased in clients taking many kinds of chemotherapeutic drugs. This issue is not particular to alkylating agents and is not the most important nursing consideration.
Rationale 3: Impaired skin integrity is an issue with clients taking many forms of chemotherapy. It is not particular to alkylating agents and is not the most important nursing consideration.
Rationale 4: Blood cells are particularly sensitive to alkylating agents. Bone marrow suppression is the primary dose-limiting toxicity of the drugs in this class. If the absolute neutrophil count (ANC) obtained by reading CBC with differential falls below 500/mm, the risk for infection increases.