Chemotherapy Side Effects

Age: ‍ years old

Gender: ‍malefemale



HISTORY:

Undergoing chemotherapy for ‍ cancer

Regimen: ‍

Currently on cycle ‍ of ‍

Last chemotherapy session was ‍ ‍daysweeks ago



Symptoms include:

nausea

‍vomiting, ‍ episodes ‍per day, ‍, ‍hematemesis

‍diarrhea, ‍ episodes ‍per day, ‍

constipation

fatigue

mouth sores

hair loss

tingling or numbness in extremities

rash

nail changes

‍fever, up to ‍°, over ‍ ‍hoursdays

chills

‍shortness of breath

‍chest pain, ‍retrosternal, ‍aching, ‍on exertionat restwith deep breath, ‍mild

Bleeding or bruising

cognitive changes

appetite loss

‍weight loss, ‍ ‍lbskg over ‍ ‍weeksmonths, ‍unintentionalintentional



Alleviating factors: ‍none, ‍effectiveineffective





EXAM:

General appearance: ‍well-appearing, ‍apparent distress

Vital signs: ‍normal, BP ‍, HR ‍, RR ‍, SpO2 ‍ %, Temp ‍°

Neck: ‍normal, ‍lymphadenopathy, ‍, c-spine ‍

Heart: ‍RRR, ‍MRG, ‍normal S1 and S2

Lungs: ‍clear bilaterally, ‍abnormal sounds, ‍retractions

Abdomen: ‍soft, ‍non-tender ‍, ‍non-distended, ‍guarding, bowel sounds ‍normal, ‍, ‍CVA tenderness ‍

Skin: ‍rashlesions on ‍

Extremities: ‍warm, ‍dry, cap refill ‍< 3> 3 sec, pulses ‍intact, ‍edema ‍bilaterally, ‍

Neurologic: cranial nerves ‍intact, strength ‍intact 5/5, sensation ‍intact, reflexes ‍intact 2+, cerebellar function ‍intact, gait ‍steady





ASSESSMENT:

‍Chemotherapy side effects ‍likelysuspectedpossible

DDx: chemotherapy-induced nausea and vomiting, neutropenia, anemia, thrombocytopenia, mucositis, alopecia, peripheral neuropathy, cardiotoxicity, hepatotoxicity, renal toxicity, infection secondary to immunosuppression, anorexia, fatigue, cachexia, electrolyte imbalances, hypersensitivity reactions, pulmonary toxicity, hemorrhagic cystitis, steroid-induced side effects, radiation therapy side effects, psychological distress, cognitive changes due to chemotherapy, hormonal changes, secondary malignancies, infusion reactions, extravasation injury





PLAN:

Investigations:

- Blood work: ‍CBC with differential, ‍electrolytes, ‍creatinine, ‍glucose, ‍LFTs, ‍bilirubin, ‍albumin, ‍INR, ‍PTT

- Urinalysis

- ECG

- Echocardiogram

- Pulmonary function tests

- CT scan of the chest/abdomen/pelvis

Treatments:

- ‍Anti-nausea medications

- ‍Pain management]

- ‍Antidiarrheals

- ‍Topical agents for mucositis

- ‍Skin care for radiation dermatitis

- ‍Renal protective strategies

- ‍Psychosocial support

Further care:

- Referral to dietitian

- Referral to social worker

- Follow-up in ‍ ‍daysweeks

- Return if symptoms worsen or if new symptoms develop such as fever, persistent vomiting, severe diarrhea, shortness of breath, or uncontrolled pain