Page 1351 - Saunders Comprehensive Review For NCLEX-RN

function studies.
5. When administering cisplatin, assess the client for
dizziness, tinnitus, hearing loss, incoordination, and
numbness or tingling of extremities.
6. Mesna may be administered with ifosfamide to reduce
the potential for ifosfamide-induced cystitis.
7. Instruct the client that cyclophosphamide, when
prescribed orally, is administered without food.
8. Instruct the client to follow a diet low in purines to
alkalinize the urine and lower uric acid blood levels.
9. Instruct the client about how to avoid infection.
10. Instruct the client to report signs of infection or
bleeding.
11. Instruct the client about good oral hygiene and the use
of a soft toothbrush.

Cyclophosphamide and ifosfamide are medications that can

cause hemorrhagic cystitis. Encourage the client to drink increased
fluids (2 to 3 L/day) during therapy, unless contraindicated.
III. Antitumor Antibiotic Medications (Box 45-2)
A. Description
1. Interfere with DNA and RNA synthesis
2. Cell cycle phase–nonspecific medications
B. Side and adverse effects
1. Nausea and vomiting
2. Fever
3. Bone marrow depression
4. Rash
5. Alopecia
6. Stomatitis
7. Gonadal suppression
8. Hyperuricemia
9. Vesication (blistering of tissue at IV site)

10. Daunorubicin may cause heart failure and

dysrhythmias.

11. Doxorubicin and idarubicin may cause

cardiotoxicity, cardiomyopathy, and
electrocardiographic changes (dexrazoxane, which is
a cardioprotective agent, may be administered with
doxorubicin to reduce cardiomyopathy).

12. Pulmonary toxicity can occur with bleomycin.

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