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.

Answer and Explanation

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.

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Correct Answer is C

Explanation

Choice A reason: Atropine is not the correct answer, as it is an anticholinergic medication that is used to treat bradycardia, not warfarin overdose. Atropine has no effect on the INR or the coagulation cascade.

Choice B reason: Epinephrine is not the correct answer, as it is a catecholamine medication that is used to treat anaphylaxis, cardiac arrest, or severe hypotension, not warfarin overdose. Epinephrine has no effect on the INR or the coagulation cascade.

Choice C reason: Vitamin K is the correct answer, as it is the antidote for warfarin overdose. Vitamin K is a fat-soluble vitamin that is essential for the synthesis of clotting factors II, VII, IX, and X. Vitamin K can reverse the effects of warfarin and lower the INR to a therapeutic range.

Choice D reason: Protamine is not the correct answer, as it is the antidote for heparin overdose, not warfarin overdose. Protamine is a protein that binds to and neutralizes heparin, but has no effect on warfarin or the INR.

A. Weigh the client. B. Measure the client's blood pressure. C. Measure the client's apical pulse. D. Offer the client a light snack.

Correct Answer is C

Explanation

Choice A reason: Weighing the client is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Weighing the client may be important for monitoring fluid balance and edema, but it is not related to digoxin therapy.

Choice B reason: Measuring the client's blood pressure is not a necessary action before administering digoxin, as it does not affect the dosage or effectiveness of the medication. Digoxin is not a blood pressure-lowering medication, but a cardiac glycoside that increases the contractility and efficiency of the heart. Measuring the blood pressure may be important for monitoring hypertension, but it is not related to digoxin therapy.

Choice C reason: Measuring the client's apical pulse is a necessary action before administering digoxin, as it can help determine the safety and appropriateness of the medication. Digoxin can cause bradycardia (slow heart rate) as a side effect, which can be dangerous and symptomatic. The nurse should check the apical pulse for one full minute and withhold the medication if the pulse is below 60 beats per minute or above 100 beats per minute. The nurse should also report any abnormal or irregular rhythms to the provider.

Choice D reason: Offering the client a light snack is not a necessary action before administering digoxin, as it does not affect the absorption or effectiveness of the medication. Digoxin can be taken with or without food. Offering the client a light snack may be important for maintaining nutrition and hydration, but it is not related to digoxin therapy.

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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?

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Correct Answer is C

Explanation

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Correct Answer is C

Explanation

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