NUR231: Cisplatin and Docetaxel - Nursing Case Study Assessment Answer

Subject Code: NUR231 Internal Code: 1AGGJB

Nursing Case Study Assessment Answer

TASK: In this task, you will provide a response to Case Study. Ensure that you specifically apply and integrate your answers with the information from your case study; avoid simply describing a disease or a drug. Case Study: 78-year-old male Nigel is a 78-year-old male who has primary stage 4 non-small cell lung cancer, which is widespread throughout his lungs, and he has substantial liver metastases. Nigel experiences shortness of breath, and pain in his chest. The pain in his right upper quadrant also pain causes him significant discomfort. He is currently taking cisplatin and docetaxel IV to treat his cancer. He is unsure whether he wants to continue with his chemotherapy, as he is very nauseous most days, and vomits in the days after each dose, and knows that his overall condition is worsening. His current medications include: • Cisplatin and docetaxel, IV infusion, every 3 weeks • Morphine IV • Ondansetron (IV on chemotherapy days, wafers at home) • Dexamethasone Even though he is taking ondansetron, he continues to experience ongoing nausea and is aware that his cancer is not improving. He is so unwell most days, that Nigel is considering declining all cancer medications, and remaining at home with his family until his approaching death. 1. From your knowledge of pathophysiology, explain the links between Nigel’s lung cancer, difficulty breathing, and metastases. 2. Consider Nigel’s secondary liver cancer – how might this impact on the pharmacokinetics of his chemotherapy medications? Ensure that you include an appropriate consideration of hepatic first pass metabolism in your answer. 3. Describe how his chemotherapy medications can be effective on treating his lung cancer. 4. Compare the mechanism of action of his current chemotherapy medications. (cisplatin and docetaxel) with an alternative cancer medication that he is not taking, nivolumab. 5. Cisplatin, docetaxel and nivolumab may all cause nausea and vomiting. Discuss one main reason why such medications can cause such symptoms, even though none of these are administered orally. Ensuring that you focus on the mechanisms that directly affect the gastrointestinal system. 6. Discuss one main adverse reaction that may occur as a result of Nigel’s morphine administration, and how would this be managed.

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