CASE STUDY Metastatic Cancer Ms Turner, aged 39, was admitted to…
Question Answered step-by-step CASE STUDY Metastatic Cancer Ms Turner, aged 39, was admitted to… CASE STUDY Metastatic Cancer Ms Turner, aged 39, was admitted to the hospital with cancer of the right breast. A lumpectomy was performed and three lymph nodes were removed. Two of these were found to contain cancer cells. Ms Turner was discharged and had follow-up radiation treatment. Four years later, she developed shortness of breath, and a bone scan showed metastasis to the right lung. The healthcare provider performed a bilateral oophorectomy (removal of both ovaries) and started Ms Turner on leuprolide 1 mg SC/day for one month. Two months later, Ms Turner reported that her shortness of breath was becoming more severe. A right thoracentesis was performed in which 500 mL of fluid was removed. One week later, a medication protocol was begun and Ms Turner received: o DOXOrubicin 50 mg o CYCLOPHOSPHamide 500 mg o 5-fluorouracil 500 mg The healthcare provider planned to repeat this regimen every 22 days. Following the first course of therapy, Ms Turner began to lose her scalp hair. Her white blood cell count was 4400/mm3. There was little therapeutic response to this course of treatment. Two months later, Ms Turner was started on a medication protocol consisting of: o ondansetron 32 mg IV 30 minutes prior to each daily chemotherapy regimen o LORazepam 2 mg IV every six hours for breakthrough nausea and vomiting o leucovorin calcium 10 mg every six hours until the serum methotrexate level was less than 0.05 micromolar o CYCLOPHOSPHamide 100 mg once daily PO o methotrexate 25 mg IV once a week o vinCRISTine 1.5 mg by IV once a week o prednisone 40 mg once daily PO Ms Turner tolerated this medication treatment poorly and developed fever, loose stools, nausea, anorexia, mouth ulcers and a white blood cell (WBC) count of 14 500/mm3. After a two-week trial, this protocol was discontinued. Ms Turner was started on letrozole 2.5 mg each day. Although Ms Turner’s metastasis was slowed for about six months, she began to do poorly again and the five-medication protocol was discontinued. Ms Turner was palliated. Questions ▪ To what class of antineoplastic agents do each of the medications received by Ms Turner belong? ▪ Why was Ms Turner initially placed on leuprolide following the bilateral oophorectomy? ▪ What is the purpose of administering medications according to a protocol or regimen of several medications at a time? ▪ Discuss why ondansetron, LORazepam and leucovorin are prescribed for Ms Turner. ▪ What measures could have been used to help Ms Turner cope with her alopecia? ▪ What nursing interventions were indicated while Ms Turner was receiving the five medication protocol? Health Science Science Nursing NURS MISC Share QuestionEmailCopy link Comments (0)
