A client's dosage schedule includes chemotherapy for each of 5 days and then no chemotherapy for 5 days. The client says, "Why don't they just keep giving me the chemo? I want to kill this cancer and get on with my life." How should the nurse respond?
1. "This chemotherapy is so strong that you cannot physically stand to take it for more than 5 days."
2. "We need to give your normal cells time to recover from the medication before you get more chemotherapy."
3. "You should let the doctors worry about that."
4. "We need to let some of the cancer cells develop into the stage where the chemotherapy can kill them."
5. "The chemotherapy is not always immediately available, so pauses are taken to allow for more stock to arrive."
2,4
Rationale 1: This is not a completely accurate statement and is not therapeutic. The client may become concerned that the chemotherapy will be fatal.
Rationale 2: The goal of chemotherapy is to destroy malignant cells with as little damage to normal cells as possible. In some cases, a pause in chemotherapy treatment is necessary to allow this recovery.
Rationale 3: This is a dismissive and non-therapeutic statement.
Rationale 4: Some chemotherapies are cell-cycle specific and kill cells only in a specific window of development. Pauses in chemotherapy are necessary to allow cells to mature into this window.
Rationale 5: While recent developments have indicated that the supply of some chemotherapy drugs is not reliable, this is not a therapeutic statement.
Global Rationale: The goal of chemotherapy is to destroy malignant cells with as little damage to normal cells as possible. In some cases, a pause in chemotherapy treatment is necessary to allow this recovery. Some chemotherapies are cell-cycle specific and kill cells only in a specific window of development. Pauses in chemotherapy are necessary to allow cells to mature into this window. The statement about the client not being able to stand the chemotherapy is not therapeutic. The statement about letting the doctor worry about it is dismissive and non-therapeutic. While recent developments have indicated that the supply of some chemotherapy drugs is not reliable, this is not a therapeutic statement.
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