Which assessment by the nurse would be a sign of neurotoxicity related to chemotherapy?

Rationale:

A. Neutropenia significantly reduces the body’s ability to fight infections, making the client vulnerable to opportunistic infections, including oral candidiasis (thrush) and systemic infections. Reinforcing infection prevention strategies, such as good hand hygiene, avoiding sick contacts, and prompt reporting of fever or oral lesions, is essential in discharge teaching.

B. While neutropenia can increase infection risk, routine monitoring specifically for periodontal disease is not the primary focus of discharge instructions. The main concern is immediate infection prevention, not chronic dental conditions.

C. Neutropenia does not increase the risk for Barrett’s esophagus. This statement is unrelated and inappropriate for discharge teaching about neutropenia.

D. While good oral hygiene is always recommended, the primary concern for neutropenic patients is prevention of opportunistic infections, not routine gingivitis. The focus is on avoiding infections that can become systemic and life-threatening.

Rationale:

A. Euphoria is not a common sign of chemotherapy-induced neurotoxicity. It may occur with certain medications affecting mood, but it is not indicative of nerve damage from chemotherapy.

B. Paresthesia, which includes numbness, tingling, or a “pins and needles” sensation, is a hallmark sign of peripheral neuropathy, a common form of neurotoxicity caused by chemotherapy. Drugs such as cisplatin, paclitaxel, and vincristine can damage peripheral nerves, leading to sensory changes, motor weakness, or altered coordination. Early recognition allows interventions to prevent further nerve damage and improve quality of life.

C. Nausea is a common gastrointestinal side effect of chemotherapy, but it is not a sign of neurotoxicity. While it may indirectly affect the nervous system through dehydration or electrolyte imbalance, it does not indicate direct nerve injury.

D. Hallucinations are not typical of chemotherapy-related neurotoxicity. They may occur with high-dose corticosteroids, CNS involvement by cancer, or certain medications, but they are not a standard indicator of peripheral neuropathy.