The common side effects of chemotherapy?

Appeared in: RUHS, Jaipur, M.Sc Nursing Entrance Exam-2019

Explanation

Chemotherapy targets rapidly dividing cells, which are abundant in the gastrointestinal (GI) tract.
This damage to the GI lining is a powerful stimulus for the brain's vomiting center (chemoreceptor trigger zone), making nausea and vomiting extremely common.
Persistent nausea and vomiting directly contribute to anorexia, or loss of appetite, creating a cluster of the most frequent side effects.

Option B: Stomatitis, or inflammation and sores in the mouth, is a common and painful side effect but is not as universally prevalent across all chemotherapy agents as nausea and vomiting.
Option C: While some chemotherapy drugs can cause constipation, diarrhea is a more common GI side effect. Constipation is often a side effect of other medications used during treatment, such as opioid pain relievers or certain antiemetics (e.g., ondansetron).
Option D: Alopecia, or hair loss, is a well-known and very common side effect of many chemotherapy drugs. However, not all chemotherapy causes hair loss, and its incidence is slightly less universal than the GI-related side effects.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Common side effects of chemotherapy as background academic context rather than a clinical decision trigger.
A nurse's primary role is the proactive assessment and management of chemotherapy side effects to improve the patient's quality of life and ensure treatment adherence.
Effective management includes administering antiemetics before treatment, educating the patient on diet modifications, and teaching them to recognize and report signs of severe side effects like dehydration or infection.
What if? If a patient is receiving a chemotherapy regimen known for high emetic risk (like cisplatin), the nursing plan must include a more aggressive multi-drug antiemetic protocol, including a 5-HT3 antagonist, a corticosteroid, and an NK1 receptor antagonist, starting before the infusion.

How to Approach the Question

First, identify the core concept of the question: 'common side effects of chemotherapy'.
Recall the mechanism of action for chemotherapy: it targets rapidly dividing cells.
Think about which normal body tissues have rapidly dividing cells. These include the lining of the GI tract, hair follicles, and bone marrow.
Evaluate the options based on this mechanism. Nausea, vomiting, and anorexia are direct results of damage to the GI tract lining.
Compare the prevalence of the side effects listed in the options. While stomatitis and alopecia are also common, GI disturbances are the most frequent and widespread across various chemotherapy agents.
Select the option that represents the most common and directly linked cluster of side effects.

Concept Tested & Keywords

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E6 Gynecology Williams p. 188-222

E6 Nursing Brunner Adult Health 3SA Vol 2 Part 3 p. 58-60

E6 Pharmacology Nursing Lilley 11e Part 3 p. 78-80

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