Comprehensive Nursing Pharmacology Q 227
Which of the following is the priority nursing diagnosis for a client undergoing chemotherapy?
A. Altered nutrition
B. Fear
C. Decreased cardiac output
D. Anxiety
Correct Answer: C. Decreased cardiac output
Decreased cardiac output is more important than the other choices because it can jeopardize the client’s life. The goal of chemotherapy is to inhibit cell proliferation and tumor multiplication, thus avoiding invasion and metastasis. But this results in toxic effects of chemotherapy due to effect or normal cells as well. Inhibition of tumor growth can take place at several levels within the cell and its environment.
Option A: With traditional agents, cell death may be delayed as a proportion of the cells die as a result of a given treatment. So, the treatment may require repeating to achieve a response. The toxicity of cytotoxic drugs is greatest during the S phase, as it is the DNA synthetic phase of the cell cycle. Vinca alkaloids and Taxanes act in the M phase and block mitotic spindle formation.
Option B: Traditional chemotherapy agents primarily affect either macromolecular synthesis and function of neoplastic cells by interfering DNA, RNA, or proteins synthesis or affecting the appropriate functioning of the preformed molecule. When interference in macromolecular synthesis or function is sufficient, it leads to cell death either due to the chemotherapeutic agent’s direct effect or by triggering apoptosis.
Option D: Combination chemotherapy is a common choice to produce effective responses as well. They appear to prevent the development of resistant clones by promoting cytotoxicity in resting and dividing cells. Cellular mechanisms that promote or suppress cell proliferation and cell differentiation are intricate, involving several genes, receptors, and signal transduction. Investigations in cancer cell biology have led to significant insight into mechanisms of apoptosis, angiogenesis, metastasis, cell signal transduction, differentiation, and growth factor modulation.