To all the doctors and nurses who know oncology... your help would be greatly appreciated!?

Mrs. J is receiving a combination chemotherapy regimen(F.A.C.) of 5-fluoroucil, doxorubicin (Adriamycin and cyclophosphamide (Cytoxan) for breast cancer.

Why has this regimen been chosen, and what can she expect?

She says she has blood in her urine and you find that it is indeed red. What will be your nursing actions?

After one week of the initial treatment you find that Mrs J has a respiratory rate of 28, a pulse of 102 and audible rales in her lung base bilaterally. What will you do?



Thank you sooo much!!!! : )

To someone who said I was cheating... definately not. I actually have already done this assignment.

I am asking everyone their answers because my friends and I worked very hard on this and feel that we were unfairly graded. However, we thought the answers we chose were very obvious. I am just trying to see if any of you say anything different. We are going to meet as a group and talk to the teacher tomorrow.

Please help : )

I'm not sure about 'why this regimen'--its not my area-but as for parts b and c:

B. Suspect hemorraghic cystitis from the cytoxan. Let the MD know right away, push fluids if possible, and be prepared to start aggressive IV hydration, and possibly to give Mesna-if it hasn't been too long since she got the cytoxan.. Do a dipstick for blood to be sure. It could just be discolored from the adria. No need to panic everybody.

C. Suspect either pneumonia (related to neutropenia, though it might be early for a nadir) or heart failure from the adriamycin. Check a temperature, check an O2 saturation, start O2 if needed, notify the MD, and get the lasix and antibiotics ready.

Side-notes: If this is a cardiac problem, she will need a followup MUGA scan. And they should really be using Doxil anyway instead of adria just for this reason. Doxil is less cardiotoxic.

Looks like someone is cheating on their nursing school homework...