An adolescent is receiving methotrexate chemotherapy after undergoing limb-salvage surgery for osteogenic sarcoma. The nurse knows the teen understands what to expect for the schedule of administration for leucovorin therapy if the teen says:

Question

1. "I don't have any pain, so I won't need to take the leucovorin this time."
2. "I don't have any nausea, so I won't need the leucovorin."
3. "I'm glad I only need one dose of the leucovorin."
4. "It is important that I receive my leucovorin on time as it protects my body from the methotrexate."

Answer 1

4
Rationale 1: Leucovorin is not administered for pain.
Rationale 2: Leucovorin is administered for nausea.
Rationale 3: One dose is not the recommended therapy.
Rationale 4: Leucovorin (citrovorum factor) is a form of folic acid that helps to protect normal cells from the destructive action of methotrexate. It is started within 24 hours of methotrexate administration and is given along with hydration therapy. Usual administration is every six hours times 72 hours or until serum methotrexate is at the desired level.
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