A client shows a proper understanding of the adverse effects of vincristine when he states:

Question

1. "I need to let my doctor know immediately if I have any weakness in my hands or feet."
2. "If I have swelling in my legs, I should keep them elevated for a while."
3. "I can take ibuprofen if I have any pain."
4. "I need to let my doctor know immediately if I took two pills instead of one."

Answer 1

Correct Answer: 1
Rationale 1: This is the correct response.
Rationale 2: Swelling of the legs can indicate a serious adverse reaction, and the client should notify the health care provider if this occurs.
Rationale 3: Pain can indicate an adverse reaction, and the client should not self-medicate but notify the health care provider. Ibuprofen is contraindicated.
Rationale 4: Vincristine is only administered IV, so a client would not take it orally.
Global Rationale: The major dose-limiting toxicity of vincristine is neurotoxicity. This manifests as motor difficulties, peripheral neuropathy, paresthesias (especially of the hands and feet), weakness, cranial nerve palsies (diplopia, hoarseness, deafness, trigeminal neuralgia, vocal cord paralysis), and decreased reflexes. Swelling of the legs can indicate a serious adverse reaction, and the client should notify the health care provider if this occurs. Bone or joint pain can indicate an adverse reaction, and the client should not self-medicate but notify the health care provider. Vincristine is only administered IV, so a client would not take it orally.