A patient on an oncology unit has been receiving ifosfamide (Ifex) for a few days. Before administering the next dose, the nurse reviews the patient's laboratory test results. Which finding would cause the nurse to hold the dose?
a. Elevated white blood cell count
b. Low hemoglobin and hematocrit levels
c. Low levels of ketones in the urine
d. Microscopic hematuria
ANS: D
The nurse should hold the dose for microscopic hematuria, because this may indicate hemorrhagic cystitis. An elevated white blood cell count is not an indication to hold the dose. Low hemoglobin and hematocrit levels are expected for a patient undergoing chemotherapy. Ketones may reveal some other problem, but they are not associated with ifosfamide.
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