Chemo101

1.  
Continuing Education

2.  The main goal of home chemotherapy is to provide
adequate treatment with minimal to no complications
o This will start in the hospital with a pre-discharge
educational session, if possible.
o Once criteria have been met, services with home health
and home infusion agencies are coordinated and the
patient is ready for home treatment.
o The home care nurse will then continue education on the
initial home visit and subsequent visits as needed.

3.  As a provider of home nursing, your goals will include
the following:
o Education related to possible complications of chemotherapy
o Performing a thorough nursing assessment to include the
following:
• Physical assessment of all body systems-to establish a baseline
for comparison
• Emotional and Psychosocial assessment- due to possible
alterations in body image related to having an IV catheter and
the attachment to equipment for chemotherapy administration.
There can also be alterations in lifestyle.
• Home assessment- the home environment is extremely
important. Does the patient have electricity, running water and a
telephone? If not, what arrangements have been made if
problems arise.

4.  Educational needs should be tailored to each individual
patient.
 Verbal and written instructions must be provided.
 Further education should be evaluated on the level of
patient’s comprehension.
 Some points you will want to cover are as follows:
o What monitoring should be done?
o What complications might arise and how can they be
avoided?
o What to do in an emergency?

5.  How is home chemotherapy administered?
o The majority of the time home chemotherapy is infused via
an ambulatory infusion pump.
o Educate the patient regarding the pump, power sources
and troubleshooting/alarms.
o Have printed instructions for the patient readily available to
refer to when the nurse is not in the home.
o Provide 24 hour phone support and instruct the patient
regarding emergencies.

6.  The home patient will need taught what to monitor while receiving
chemotherapy. Even though each doctor may have specific items for
the patient to monitor, the most common are as follows:
o Diet- Encourage fluids, eat bland foods if nauseated, monitor for dehydration, take
medications for side effects as directed by MD.
o Oral care- assess for ulcers and thrush, rinse mouth several times daily
o Neutropenic precautions- No fresh fruits or vegetables, do not work in gardens or
clean up after animals if neutropenic
o Signs of Infection- this would include general signs of infection along with signs or
symptoms of IV catheter infection. Make patient aware to monitor for temperature
elevations (100.5 F or as directed by MD office), chills, fever drainage (any incisions
or wounds) or change in drainage indicating infection, also drainage at catheter
insertion site.
o IV catheter site- the patient needs to monitor site daily for tenderness, redness and
drainage. Also, if they have difficulty with flushing or experience an “odd” sensations
when flushing their catheter, they should notify their home care nurse or MD
immediately.
o Encourage your patients to get a notebook to record all of these items and to have it
handy so that you can assess the results on your visits. The patient can also take

7.  When to call the home care nurse:
o If there is bleeding at the catheter site
o If there is damage to the IV line, the IV line is cut in any
way, “falls out”, chemotherapy is leaking or connection
comes apart
o If patient is experiencing a problem with the infusion pump
o If Huber needle becomes dislodged or falls out

8.  Home chemotherapy is a safe and cost effective
alternative to traditional in-hospital treatment for cancer
patients. Efforts should be made to overcome barriers to
a more wide-spread adoption of this model of care when
possible. When implemented and managed properly,
home chemotherapy treatment can vastly improve the
quality of life for the cancer patient while going through
this life-altering event.

9.  Definition of biological response modifiers. (2012). Retrieved August 7,
2015, from www.medicinenet.com.
 Gupta, S. & Kanodia, AK. (2002). Biological response modifiers in cancer
therapy. National Medical Journal of India, 15 (4), 202-7.
 How is chemotherapy given? (n.d.). Retrieved August 6, 2015, from
www.chemocare.com.
 Intravenous Nursing: Clinical Principles and Practice, second edition.
Chapter 18. Infusion Therapy in Clinical Practice, 1st edition.
 Medline Plus (http://www.nlm.nih.gov/medlineplus/ency/article/002324.htm)
 Types of chemotherapy. (n.d.). Retrieved August 6, 2015, from
www.chemocare.com.
 Types of chemotherapy. (n.d.). Retrieved August 6, 2015, from
www.uihealthcare.org.
 www.cancer.org/treatment