A nurse is caring for a patient with cancer who has been ...

[ssal]

A nurse is caring for a patient with cancer who has been undergoing chemotherapy. The patient has oral mucositis as a result of the chemotherapy, and the provider has ordered palifermin (Kepivance).
 
  Which is an appropriate nursing action when giving this drug?
  a. Administering the drug as a slow IV infusion
  b. Flushing the IV line with heparin before infusing the drug
  c. Giving the drug within 6 hours of the chemotherapy
  d. Warning the patient about the potential for distortion of taste

Question 2

A patient with gastroesophageal reflux disease (GERD) is to begin taking oral metoclopramide (Reglan). The patient asks the nurse about the medication. Which response by the nurse is correct?
 
  a. After 3 months, if the drug is not effective, you may need to increase the dose.
  b. Metoclopramide may cause hiccups, especially after meals.
  c. Serious side effects may occur but will stop when the drug is discontinued.
  d. You should take the drug 30 minutes before each meal and at bedtime.

[elizabethrperez]

Answer to Question 1

ANS: D
Palifermin is generally well tolerated but commonly causes reactions involving the skin and mouth, including taste distortion. The drug should be given as an IV bolus. Palifermin binds with heparin, so the IV line should not be flushed with heparin before giving palifermin. If the interval between administration of palifermin and the chemotherapeutic drugs is too short, palifermin actually may increase the severity and duration of oral mucositis; therefore, palifermin should be given 24 hours before the chemotherapeutic drugs.

Answer to Question 2

ANS: D
Metoclopramide should be given 30 minutes before meals and at bedtime. Metoclopramide should not be used long term, and increasing the dose after 3 months of therapy is not recommended. Metoclopramide is used to treat hiccups; it does not cause hiccups. Tardive dyskinesia is a serious and irreversible side effect.

[ssal]

Thank you!

[elizabethrperez]

Always glad to help...