I have four discussions. Please read all four before responding. All questions in every discussion needs to be answered. No plagiarism. Does not need to be in SPA style…. Please understand these are four separate discussion. Each discussion has its own set of questions.

Discussion #1 —A dose-limiting toxicity or side effect is one that results in dose delay, dose reduction, or dose/drug discontinuation. A dose-limiting toxicity is not one where only the infusion rate is changed (ex. infusion reaction with ritualism) but where a true modification to the dose occurs. To answer this discussion question, reflect on some of the more challenging dose-limiting toxicities you assess and manage in your practice. If you need help deciding on a dose-limiting toxicity to discuss, refer to Table 7 in the course eBook (Characteristics of Chemotherapeutic Agents). In aIDition the course eBook is a great reference for assessment and evidence-based strategies.

Answer the following questions completely with details to earn credit for post:

1. Pick ONE dose-limiting toxicity related to a particular chemotherapy agent (actually state the agent in your post).  
2. Provide two (2) key components of your nursing assessment that should be routinely performed to identify or monitor the one toxicity you chose.
3. Discuss two (2) evidence-based pharmacological and/or non-pharmacological management strategies for toxicity you chose.

   This is to be an interactive learning environment so be sure to view what your peers are posting and reply to their posts if you have recommendations for them based on your own practice or if you have questions of them on how their policies/procedures might benefit  you.
   

   Discussion #2—The nurse’s role in monitoring cumulative dose is a necessary and expected step in the safe administration verification process, as part of an assessment of the overall treatment plan. 

   Answer the following questions completely to earn credit for post:

1. Discuss 2 areas of your practice that require some improvement related to monitoring, verifying, and/or documenting cumulative doses of chemotherapy.
2. How might you suggest these improvements be developed and implemented in your practice/facility?                                                                                                                                                                    This is to be an interactive learning environment so be sure to view what your peers are posting and reply to their posts if you have recommendations for them based on your own practice or if you have questions of them on how their policies/procedures might benefit you.
   

    

    Discussion # 3—To earn credit for this discussion, answer the following questions completely including specific details and examples:

1.        What is your personal safe handling practices you currently use to reduce your exposure risk to hazardous drugs?

2.        Based on what you learned in this course, what will you change or do you plan to change in your practice to reduce your personal risk to hazardous drugs?

3.        What do you teach your patients and their caregivers to assure that they reduce their own exposure to hazardous drugs after leaving your care/going home?

This is to be an interactive learning environment so be sure to view what your peers are posting and reply to their posts if you have recommendations for them based on your own practice or if you have questions of them on how their policies/procedures might benefit you.

Discussion #4—Consider a patient receiving combination therapy, perhaps R-CHOP or ACTH, that includes BOTH a monoclonal antibody or other targeted therapy along with toxicity chemotherapy.   Demonstrate your understanding of concepts related to combination therapy that includes a monoclonal antibody or targeted therapy by posting how you would explain the following to the patient at a level (e.g., 5th grade) they would understand.

For this discussion, aIDress EACH of the four following points in your discussion post – REMEMBER you are explaining these points to a patient! To earn credit, your post must be at a level the patient can understand (e.g. 5th grade level).

1.        What combination therapy regimen are you posting about? (Regimen must include BOTH a monoclonal antibody/targeted therapy plus toxicity chemotherapy)

2.        How would you explain to your patient the rationale for why they are receiving combination therapy (toxicity chemotherapy plus monoclonal antibody/targeted therapy) at a level the patient would understand?

3.        How do monoclonal antibodies differ from chemotherapy?

4.        What are some important points to discuss with the patient regarding this therapy?  Be sure to list 2 key teaching points for EACH agent in the regimen.

This is to be an interactive learning environment so be sure to view what your peers are posting and reply to their posts if you have recommendations for them based on your own practice or if you have questions of them on how their policies/procedures might benefit you.