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Nursing Management of the Common Side Effects of Chemotherapy

A. Bone marrow suppression leads to:

1. Decreased WBC count (immunosuppression).

  • Avoid crowds; people with infections and small children when WBC count is low
  • Consume a low-bacteria diet. Avoid overcooked meat and raw fruits and vegetables

2. Decreased platelet count (thrombocytopenia)

  • When shaving use ellectirc razon only
  • Avoid contact sports and other activities that may cause trauma
  • If trauma does occur, apply ice to the area and seek medical assistance
  • Avoid dental work or other invasive procedures
  • Avoid aspirin and aspirtin-containing products

3. Decrease hemoglobin and hematocrit (anemia).

B. Gastrointestinal effcts : anorexia, nausea, vomiting, and diarrhea
1. Client education for mainting adequate nutrition , and fluid and electrolyte balance

  • Eat frequent, small, low-fat meals
  • Avoid spicy and fatty foods
  • Avoid extremely hot foods

Nursing management of inadequate nutrition and fluit and elctrolyte imbalances

  • Administer antiemetics prior to chemotherapy
  • Weigh client routinely and monitor for weight loss

C. Stomatitis (infammation of the mouth) and mucositosis
1. Client education for stomatitis and mucositosis

  • Use a soft toothbrush. Mouth swabs may be needed during an acute episode
  • Avoid mouthwashes containing alcohol. do not use lemon glycerin swabs or dental floss
  • Consider using chlorhexidine mouthwash (Peridex) to decrease risk of hemorrhage and protect gums from trauma
  • For Xerostomia, apply lubricating and moisturizing agents to protect the mucopus membranes from trauma and infection
  • Consicder using “artificial saliva” and hard candy or mints to help with dryness of the mouth
  • Avoid smoking and alcohol, which can further irritate the oral mucosa

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