AB017. S3B-3. Guidelines for care of the patient receiving chemotherapy

Abstract: Clinical Practice Guideline: Medical/Nursing Management of Cholangiocarcinoma patients on weekly Gemcitabine and Cisplatin. Goals/outcomes: (I) patient will demonstrate outcomes below: (i) patient and/or family will be able to describe their disease and disease process; (ii) patient and/or family will be able to describe signs/symptoms of disease and treatment to monitor for and report to clinical team; (iii) patient and/or family will have a working knowledge of all medications involved in their treatment profile; (iv) patient and/or family will be able to list the common side effects of their medications (e.g., chemotherapeutic agents); (v) patient and/or family will be able to list the measurements to prevent and manage side effects of their medications (e.g., chemotherapeutic agents); (vi) ambulatory patients will have decreased inpatient admissions. Assessment/interventions: (I) list assessment findings: (i) document presence or absence of allergies/history of other hypersensitivity reactions: 5, IV-A;6,IV-A; (ii) document patient’s comprehension regarding chemotherapy regimens (and associated supportive medications e.g., anti-emetics, anti-pyretic) including information regarding disease: 5,IV-A;6,IV-A; (iii) document assessment of the patient’s psychosocial concerns and need for referrals and/or support and document any actions taken by clinical team: 5,IV-A;6,IV-A; (iv) assess and monitor for common Gemcitabine/Cisplatin related side effects (Flu-like symptoms, Fatigue, Nausea/Vomiting, Myelosuppression, Kidney Toxicity and/or Peripheral Neuropathy): 2,III-B;3,III-B 4,IV-A;7,V-B;8,V-B; (II) list interventions as it is related to assessment findings above: (i) evaluate and document in specific chemotherapy management assessment tool any interim change in medical history or reactions: 1,IV-A;2,III-B;7,V-B;9,V-B; (ii) evaluate at each session that patient understands management of chemotherapy treatment side-effects (e.g., Flu-like symptoms, Fatigue, Nausea/Vomiting, Myelosuppression, Kidney Toxicity and/or Peripheral Neuropathy): 1,IV-A;2,III-B;7,V-B; 9,V-B; (iii) evaluate and document in specific chemotherapy management assessment tool any interim need for referrals and or psychosocial assessments: 1,IV-A; 2,III-B; 7,V-B;9,V-B; (iv) monitor and measure patient report of manageable and controllable side effects and evaluate patient at each visit for side effects of treatment: 1,IV-A; 2, 7,V-B;9,V-B.

Keywords: Chemotherapy; side effects; gemcitabine; cisplatin; anti-emetics; supportive care