Page 1353 - Saunders Comprehensive Review For NCLEX-RN

4. When administering fluorouracil, assess for signs of
cerebellar dysfunction, such as dizziness, weakness,
and ataxia, and assess for stomatitis and diarrhea,
which may necessitate medication discontinuation.
5. When administering fluorouracil or methotrexate,
instruct the client to use sunscreen and wear
protective clothing to prevent photosensitivity
reactions.

When administering methotrexate in large doses, prepare to

administer leucovorin as prescribed to prevent toxicity. This is known as
leucovorin rescue.
V. Mitotic Inhibitor Medications (Vinca Alkaloids) (Box 45-4)
A. Description
1. Mitotic inhibitors prevent mitosis, causing cell death.
2. Mitotic inhibitors are cell cycle phase–specific and act
on the M phase.
B. Side and adverse effects
1. Leukopenia

2. Neurotoxicity with vincristine, manifested as

numbness and tingling in the fingers and toes;
constipation, and paralytic ileus can also occur.
3. Ptosis
4. Hoarseness
5. Motor instability
6. Anorexia, nausea, and vomiting
7. Peripheral neuropathy
8. Alopecia
9. Stomatitis
10. Hyperuricemia
11. Phlebitis at IV site

C. Interventions: Refer to Section I, C (Antineoplastic

Medications—General Interventions).
1. Monitor for hoarseness.
2. Assess eyes for ptosis.
3. Assess motor stability and initiate safety precautions
as necessary.
4. Monitor for neurotoxicity with vincristine, manifested
as numbness and tingling in the fingers and toes.
5. Monitor for constipation and paralytic ileus.
VI. Topoisomerase Inhibitors (Box 45-5)
A. Description
1. Block an enzyme needed for DNA synthesis and cell
division

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