Page 1347 - Saunders Comprehensive Review For NCLEX-RN

below 18% conventional units (0.18 SI
units); notify the PHCP.
g. Monitor for fever, sore throat, unusual
bleeding, and signs and symptoms of
infection.
h. Inform the client that loss of appetite
also may be the result of taste changes
or a bitter taste in the mouth from the
medications.
i. Monitor for nausea and vomiting and
provide a high-calorie diet with
protein supplements.
j. Administer antiemetics several hours
before chemotherapy and for 12 to 48
hours after as prescribed, because
antineoplastic medications stimulate
the vomiting center in the brain.
k. Encourage hydration; IV fluids are
administered before and during
therapy.
l. Promote a fluid intake of at least 2000
mL/day to maintain adequate renal
function.

Antineoplastic medication causes the rapid

destruction of cells, resulting in the release of uric
acid. Allopurinol may be prescribed to lower the
serum uric acid level.
2. Safe and effective care environment
a. Prepare IV chemotherapy in an air-
vented space (biological safety
cabinet).
b. Wear appropriate personal protective
equipment (PPE), including gloves,
gown, eye protectors, and mask as
indicated, to reduce exposure
whenever there is a risk of hazardous
medications being released into the
environment.
c. Nurses who are pregnant should avoid
chemotherapy preparation or the
administration of chemotherapy.
d. Discard IV equipment in designated
(biohazard) containers.
e. Administer antineoplastic medication
precisely as prescribed to maximize
antineoplastic effects while allowing

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