A patient receiving a chemotherapy agent that is a vesicant should be monitored for which adverse effect?
Dehydration due to the emetogenic effect of the drug
Infiltration of the intravenous fluid containing the chemotherapy agent into the surrounding skin
The presence of blood in the urine or stool
Orthostatic hypotension due to fluid expansion in the vascular system
The Correct Answer is B
A. While nausea and vomiting are common side effects of many chemotherapy agents, this is not specific to vesicants, which are drugs that can cause tissue damage if they leak outside the vein.
B. Vesicant chemotherapy agents can cause severe tissue damage, necrosis, and ulceration if they extravasate (leak into surrounding tissue). Close monitoring of the IV site for signs of redness, swelling, or pain is essential.
C. This may indicate gastrointestinal or bladder irritation from other types of chemotherapy agents, but it is not the hallmark concern with vesicants.
D. This is unrelated to vesicant properties. Orthostatic hypotension may occur from dehydration or autonomic effects, but not from vesicant infiltration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D"]
Explanation
A. Diabetic clients should not remove callouses themselves due to the risk of cuts or infections, which can lead to serious complications. Callous removal should be done by a healthcare professional (e.g., a podiatrist).
B. Toenails should be cut straight across, not at an angle, to prevent ingrown toenails, which can become infected and are especially dangerous for individuals with diabetes.
C. Daily foot inspection helps detect early signs of skin breakdown, blisters, or infections. Early detection is crucial because diabetes can reduce sensation and blood flow, delaying wound healing.
D. Diabetes increases the risk of eye conditions such as diabetic retinopathy, glaucoma, and cataracts. Annual eye exams are essential for early detection and treatment to prevent vision loss.
Correct Answer is D
Explanation
A. Cold sweats are more commonly associated with hypoglycemia, not DKA.
B. Bradycardia (slow heart rate) is not a typical finding in DKA, where tachycardia is more likely due to dehydration.
C. Cyanosis (bluish discoloration) is seen in severe respiratory or cardiac conditions, not a hallmark of DKA.
D. Kussmaul respirations (deep, rapid breathing) are a hallmark sign of DKA. They represent the body’s attempt to compensate for metabolic acidosis by blowing off excess CO₂.
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