A nurse is caring for a client who is receiving cisplatin, a platinum compound, as part of chemotherapy for lung cancer. The nurse should administer amifostine, a chemoprotective agent, to the client to protect which of the following organs from nephrotoxicity caused by cisplatin?

Choice A reason:

The liver is not the organ that is protected by amifostine, a chemoprotective agent, from nephrotoxicity caused by cisplatin, a platinum compound that crosslinks DNA strands and prevents cell division. Cisplatin is used to treat lung cancer, a type of cancer that affects the respiratory system. The liver is not the primary target of cisplatin's toxicity, although it can cause hepatotoxicity in some cases. Amifostine does not prevent hepatotoxicity caused by cisplatin.

Choice B reason:

The kidneys are the organ that is protected by amifostine, a chemoprotective agent, from nephrotoxicity caused by cisplatin, a platinum compound that is used to treat lung cancer. Nephrotoxicity is a common and potentially serious adverse effect of cisplatin, which can cause acute or chronic renal failure, electrolyte imbalance, and metabolic acidosis. Nephrotoxicity is caused by the accumulation of cisplatin and its metabolites in the renal tubules, which leads to tubular damage and dysfunction. Amifostine can prevent or reduce nephrotoxicity caused by cisplatin. Amifostine is a prodrug that is converted to an active form by alkaline phosphatase in the normal tissues, but not in the tumor tissues. The active form of amifostine scavenges free radicals and protects the renal cells from oxidative stress.

Choice C reason:

The heart is not the organ that is protected by amifostine, a chemoprotective agent, from nephrotoxicity caused by cisplatin, a platinum compound that is used to treat lung cancer. The heart is not the primary target of cisplatin's toxicity, although it can cause cardiotoxicity in some cases. Amifostine does not prevent cardiotoxicity caused by cisplatin.

Choice D reason:

The lungs are not the organ that is protected by amifostine, a chemoprotective agent, from nephrotoxicity caused by cisplatin, a platinum compound that is used to treat lung cancer. The lungs are the primary site of action of cisplatin, as it kills the lung cancer cells. Amifostine does not protect the lung cancer cells from cisplatin's cytotoxic effect, as it does not reach them in its active form. Amifostine does not prevent pulmonary toxicity caused by cisplatin.

Choice A reason:

Cardiotoxicity is not a common adverse effect of cyclophosphamide, an alkylating agent that crosslinks DNA strands and prevents cell division. Cyclophosphamide is used to treat ovarian cancer, a type of cancer that affects the female reproductive organs. Cardiotoxicity may be caused by other drugs, such as anthracyclines and trastuzumab, which are used to treat other types of cancer.

Choice B reason:

Hemorrhagic cystitis is a common and potentially serious adverse effect of cyclophosphamide, an alkylating agent that is used to treat ovarian cancer. Hemorrhagic cystitis is inflammation and bleeding of the bladder, which can lead to infection, obstruction, and renal failure. Hemorrhagic cystitis is caused by the metabolite of cyclophosphamide, acrolein, which irritates the bladder lining. The nurse should administer mesna, a chemoprotective agent, to the client to prevent hemorrhagic cystitis. Mesna binds to acrolein and inactivates it, preventing it from damaging the bladder. The nurse should also encourage the client to drink plenty of fluids and void frequently to flush out the drug and its metabolites.

Choice C reason:

Nephrotoxicity is not a common adverse effect of cyclophosphamide, an alkylating agent that is used to treat ovarian cancer. Nephrotoxicity may be caused by other drugs, such as cisplatin and methotrexate, which are used to treat other types of cancer.

Choice D reason:

Neurotoxicity is not a common adverse effect of cyclophosphamide, an alkylating agent that is used to treat ovarian cancer. Neurotoxicity may be caused by other drugs, such as vincristine and paclitaxel, which are used to treat other types of cancer.