The nurse is caring for a child who is receiving chemotherapeutic agents. Prior to administering the chemotherapy, the nurse must check which of the following and report to the physician if the results are high?
a. cardiac enzymes
b. hemoglobin and oxygen saturation levels
c. thyroxine
d. liver transaminase and bilirubin levels
D
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A Incorrect. Some chemotherapy drugs can cause ECG changes and rapidly progressive heart failure. The heart would be monitored with ECG and cardiac ejection fractions. Cardiac enzymes are measured to diagnose myocardial injury.
B Incorrect. The nurse might be concerned if hemoglobin and oxygen saturation levels were slightly low, not high.
C Incorrect. Thyroxine or T4 is not affected by chemotherapy.
D Correct. Prior to administering the chemotherapy, the nurse must check liver transaminase and bilirubin levels and report to the physician if the results are high. Liver toxicity seen with some chemotherapeutic agents ranges from elevation of hepatic enzymes to liver fibrosis and liver damage caused by long term use of these drugs. High transaminase and bilirubin levels may require a dose reduction or postponement of the agents.
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