The nurse is caring for a patient who has been receiving vinorelbine (Navelbine) for about 5 days. Which assessment finding in this patient would cause the nurse to withhold the next dose and notify the prescriber?
a. Alopecia
b. Dyspnea and cough
c. Neutrophil count of 1200/mm3
d. Peripheral neuropathy
ANS: B
The nurse should withhold the dose if the patient has new-onset cough and dyspnea, because these may indicate the development of interstitial pulmonary changes and acute respiratory distress syndrome. Alopecia would not cause the nurse to withhold the dose. Neutropenia is expected and is not at a critical level. Although this count is low, it would not prevent administration of the medication. Peripheral neuropathy is expected with vinorelbine.
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