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: Vomiting is not a specific sign of a hemolytic reaction, as it can be caused by many other factors, such as anesthesia, infection, or medication. Vomiting may occur in other types of transfusion reactions, such as allergic or febrile reactions, but it is not indicative of hemolysis.
Choice B reason: Flushing is not a specific sign of a hemolytic reaction, as it can be caused by many other factors, such as fever, infection, or medication. Flushing may occur in other types of transfusion reactions, such as allergic or febrile reactions, but it is not indicative of hemolysis.
Choice C reason: Dyspnea is a specific sign of a hemolytic reaction, as it indicates that the client is experiencing respiratory distress due to the release of hemoglobin and its breakdown products into the bloodstream. Dyspnea may be accompanied by chest pain, cough, wheezes, or crackles. Dyspnea is a life-threatening symptom that requires immediate intervention.
Choice D reason: Hypotension is not a specific sign of a hemolytic reaction, as it can be caused by many other factors, such as blood loss, dehydration, or medication. Hypotension may occur in other types of transfusion reactions, such as septic or anaphylactic reactions, but it is not indicative of hemolysis.
Correct Answer is B
Explanation
Choice A reason: Warfarin PO is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a slow onset of action and requires frequent monitoring of the INR (international normalized ratio). Warfarin may be used for long-term anticoagulation, but it is not effective for preventing the formation of new clots.
Choice B reason: Enoxaparin subcutaneous is a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a rapid onset of action and does not require frequent monitoring of the coagulation status. Enoxaparin is a low-molecular-weight heparin that inhibits the formation of thrombin and prevents the growth of existing clots.
Choice C reason: Aspirin PO is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it has a weak anticoagulant effect and may increase the risk of bleeding. Aspirin is an antiplatelet agent that inhibits the aggregation of platelets and prevents the formation of arterial clots, but it is not effective for preventing venous clots.
Choice D reason: Heparin infusion is not a suitable medication for DVT prophylaxis in the immediate postoperative period, as it requires continuous intravenous administration and frequent monitoring of the aPTT (activated partial thromboplastin time). Heparin is an unfractionated heparin that inhibits the formation of thrombin and prevents the growth of existing clots, but it has a narrow therapeutic window and a high risk of bleeding.
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