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Cardiotoxicity and extravasation injury are not common adverse effects of cyclophosphamide. Cardiotoxicity is the damage to the heart muscle caused by certain drugs, such as anthracyclines (e.g., doxorubicin) or trastuzumab. Extravasation injury is the leakage of a vesicant drug (a drug that causes tissue damage) into the surrounding tissues, causing pain, swelling, necrosis, and infection. Cyclophosphamide is not a vesicant drug, but vinca alkaloids (e.g., vincristine) or platinum compounds (e.g., cisplatin) are .

Peripheral neuropathy and pulmonary fibrosis are not common adverse effects of cyclophosphamide. Peripheral neuropathy is the damage to the nerves of the peripheral nervous system, causing numbness, tingling, pain, or weakness in the hands or feet. Pulmonary fibrosis is the scarring of the lung tissue, causing shortness of breath, cough, and reduced oxygen levels. These complications are more likely to occur with drugs such as taxanes (e.g., paclitaxel) or bleomycin .

Hepatotoxicity and gastrointestinal toxicity are not specific adverse effects of cyclophosphamide. Hepatotoxicity is the damage to the liver cells caused by certain drugs, such as methotrexate or acetaminophen. Gastrointestinal toxicity is the irritation of the mucous membranes of the digestive tract, causing nausea, vomiting, diarrhea, or mucositis. These side effects can occur with many chemotherapy drugs, but they are not unique to cyclophosphamide .

Hearing loss is not a common side effect of paclitaxel, a natural product that interferes with the growth of cancer cells. Hearing loss may be caused by other factors, such as aging, exposure to loud noises, or ear infections.

Chest pain and shortness of breath are not signs of peripheral neuropathy, but may indicate cardiac or pulmonary problems. Paclitaxel can cause hypersensitivity reactions, such as flushing, rash, and dyspnea, but these usually occur during or shortly after the infusion.

Redness and swelling at the infusion site are not signs of peripheral neuropathy, but may indicate phlebitis or infiltration. Phlebitis is inflammation of the vein, which can cause pain, warmth, and redness along the vein. Infiltration is leakage of the drug into the surrounding tissue, which can cause swelling, pain, and skin damage. The nurse should monitor the infusion site for these complications and stop the infusion if they occur.

Nausea, vomiting, and diarrhea are not signs of pulmonary fibrosis, but may occur as common side effects of bleomycin and other chemotherapy drugs. The nurse should provide antiemetic drugs, fluids, and electrolytes to prevent dehydration and electrolyte imbalance in the client.

Fever, chills, and sore throat are not signs of pulmonary fibrosis, but may indicate infection, which is a risk factor for clients receiving chemotherapy. Chemotherapy drugs can suppress the immune system and make the client more susceptible to infections. The nurse should monitor the client's temperature, white blood cell count, and cultures, and administer antibiotics as prescribed.

Jaundice, dark urine, and claycolored stools are not signs of pulmonary fibrosis, but may indicate liver damage, which is another possible adverse effect of bleomycin. Bleomycin can cause hepatotoxicity, which is toxicity to the liver cells that can impair the liver's function. The nurse should monitor the client's liver function tests, such as serum bilirubin, alkaline phosphatase, and transaminases, and report any abnormalities to the provider.

Blocking the estrogen receptors on the cancer cells and inhibiting their growth is the mechanism of action of tamoxifen, a selective estrogen receptor modulator (SERM) that is used to treat breast cancer. Tamoxifen is not effective for prostate cancer, which is stimulated by testosterone, not estrogen.

Stimulating the production of testosterone and increasing the sensitivity of the cancer cells to chemotherapy is not the mechanism of action of leuprolide, a hormone that is used to treat prostate cancer. Leuprolide does not increase testosterone, but decreases it. Increasing testosterone would worsen prostate cancer, not improve it.

Altering the metabolism of cortisol and inducing apoptosis of the cancer cells is not the mechanism of action of leuprolide, a hormone that is used to treat prostate cancer. Leuprolide does not affect cortisol, but testosterone. Cortisol is a glucocorticoid hormone that regulates stress response, inflammation, and metabolism. Apoptosis is a process of programmed cell death that can be triggered by some chemotherapy drugs, such as cisplatin and doxorubicin.