Page 1346 - Saunders Comprehensive Review For NCLEX-RN

administration) to ensure that the client receives
optimal doses of chemotherapy medications.

Side and adverse effects from chemotherapy result from the

effects of the antineoplastic medication on normal cells.
B. Side and adverse effects

1. Mucositis
2. Alopecia
3. Anorexia, nausea, and vomiting
4. Diarrhea
5. Anemia
6. Low white blood cell count (neutropenia)
7. Thrombocytopenia
8. Infertility, sexual alterations
9. Neuropathy
C. General interventions

1. Physiological integrity
a. Monitor complete blood cell count,
white blood cell count, platelet count,
uric acid level, and electrolytes.
b. Initiate bleeding precautions if
thrombocytopenia occurs.
c. When the platelet count is less than
3
9
50,000 mm (50 × 10 /L), minor trauma
can lead to episodes of prolonged
bleeding; when less than 20,000 mm 3
9
(20 × 10 /L), spontaneous and
uncontrollable bleeding can occur;
withhold the medication if the platelet
count drops (according to agency
policy) and notify the primary health
care provider (PHCP). Bleeding
precautions are initiated.
d. Monitor for petechiae, ecchymoses,
bleeding of the gums, and nosebleeds,
because the decreased platelet count
can precipitate bleeding tendencies.
e. Avoid intramuscular injections and
venipunctures as much as possible to
prevent bleeding.
f. Withhold the medication and initiate
neutropenic precautions if the
segmented neutrophil count decreases

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