Page 1348 - Saunders Comprehensive Review For NCLEX-RN

normal cells to recover.
f. Monitor for phlebitis with IV
administration, because these
medications may irritate the veins.
g. Vesicants should be administered
through a central line when possible; if
a peripheral line is used, blood return
should be checked prior to
administration.
h. As prescribed, reduce IV site pain by
altering IV rates or warming the
injection site to distend the vein and
increase blood flow.
i. Monitor for extravasation (leakage of
medication into surrounding skin and
subcutaneous tissue, which causes
tissue necrosis) and notify the PHCP if
this occurs; heat or ice is applied
depending on the medication, and an
antidote may be injected into the site.
3. Psychosocial integrity
a. Instruct the client about the possibility
of hair loss and that varying degrees of
hair loss may occur after the first or
second treatment.
b. Discuss the purchase of a wig before
treatment starts and consider cutting
hair short.
c. Inform the client that new hair growth
will occur several months after the
final treatment.
d. Instruct the client about the need for
contraception, because these
medications have teratogenic effects.
e. Discuss the potential effect of infertility,
which may be irreversible.
f. Encourage pretreatment counseling and
encourage sperm banking or
preservation of eggs if the client is still
of childbearing age.
4. Health promotion and maintenance
a. Instruct the client, if diarrhea is a
problem, to avoid spicy foods, high-
fiber foods, and foods that are hot in
temperature, which increase
peristalsis.
b. Instruct the client to inspect the oral
mucosa frequently for erythema and

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