A nurse on an oncology unit is preparing to administer doxorubicin to a client who has breast cancer. Prior to beginning the infusion, the nurse verifies the client's current cumulative lifetime dose of the medication. For which of the following reasons is this verification necessary?
Exceeding the lifetime cumulative dose limit of doxorubicin might cause extravasation.
Exceeding the lifetime cumulative dose limit of doxorubicin might produce red tinged urine and sweat.
An excess amount of doxorubicin can lead to cardiomyopathy.
An excess amount of doxorubicin can lead to myelosuppression.
The Correct Answer is C
Choice A reason: This is incorrect because extravasation is not related to the lifetime cumulative dose limit of doxorubicin, but to the leakage of the medication from the vein into the surrounding tissue. Extravasation can cause severe tissue damage and necrosis, and should be prevented by using a central venous catheter and monitoring the infusion site.
Choice B reason: This is incorrect because red tinged urine and sweat are not related to the lifetime cumulative dose limit of doxorubicin, but to the normal excretion of the medication from the body. Red tinged urine and sweat are expected side effects of doxorubicin and do not indicate toxicity or harm.
Choice C reason: This is correct because an excess amount of doxorubicin can lead to cardiomyopathy, which is a serious and potentially fatal complication of the medication. Cardiomyopathy is a condition in which the heart muscle becomes weak and unable to pump blood effectively. The risk of cardiomyopathy increases with the cumulative lifetime dose of doxorubicin, which should not exceed 450 to 550 mg/m2.
Choice D reason: This is incorrect because myelosuppression is not related to the lifetime cumulative dose limit of doxorubicin, but to the dose-dependent effect of the medication on the bone marrow. Myelosuppression is a condition in which the production of blood cells is reduced, leading to anemia, leukopenia, and thrombocytopenia. Myelosuppression can be managed by adjusting the dose and frequency of doxorubicin and monitoring the blood counts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Black cohosh is an herbal supplement that is used to treat menopausal symptoms, such as hot flashes and mood swings. It does not have a significant interaction with warfarin and does not affect the coagulation status of the client.
Choice B reason: Echinacea is an herbal supplement that is used to boost the immune system and prevent or treat common colds and infections. It does not have a significant interaction with warfarin and does not affect the coagulation status of the client.
Choice C reason: Feverfew is an herbal supplement that is used to treat migraines, arthritis, and fever. It has a significant interaction with warfarin and can increase the risk of bleeding and bruising. It can also reduce the effectiveness of warfarin and alter the client's international normalized ratio (INR).
Choice D reason: Flaxseed is an herbal supplement that is used to lower cholesterol, blood pressure, and inflammation. It does not have a significant interaction with warfarin and does not affect the coagulation status of the client.
Correct Answer is A
Explanation
Choice A reason: Using an electric razor while on warfarin is the correct instruction. Warfarin is an anticoagulant that inhibits the formation of blood clots and prolongs the bleeding time. Using an electric razor can reduce the risk of cuts and bleeding while shaving. The client should avoid using sharp objects or instruments that can cause injury or trauma.
Choice B reason: Doubling the dose of warfarin if a dose is missed is not the correct instruction. This is a dangerous and potentially fatal advice, as it can cause overdose and severe bleeding. The client should take the missed dose as soon as possible, unless it is close to the next scheduled dose, in which case the client should skip the missed dose and resume the regular dosing schedule. The client should never take extra doses or change the dose without consulting the provider.
Choice C reason: Mild nosebleeds being common during initial treatment is not the correct instruction. This is a false and misleading statement, as nosebleeds are not a normal or expected side effect of warfarin therapy. Nosebleeds can indicate bleeding problems or complications, such as thrombocytopenia, which is a low platelet count. The client should report any nosebleeds or other signs of bleeding, such as bruising, petechiae, hematuria, or melena, to the provider immediately.
Choice D reason: Increasing fiber intake to reduce the adverse effect of constipation is not the correct instruction. This is an irrelevant and unnecessary recommendation, as constipation is not a common or serious adverse effect of warfarin therapy. Constipation can be caused by many factors, such as diet, hydration, activity, or medication. The client should maintain a balanced and consistent diet, drink plenty of fluids, and exercise regularly to prevent constipation. The client should also avoid foods that are high in vitamin K, such as green leafy vegetables, as they can interfere with the effect of warfarin.
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