A patient is receiving fluorouracil (Adrucil) as a continuous intravenous dose to treat a solid tumor. The patient reports soreness and blisters in the mouth, loose stools, and tingling of the hands and feet. What will the nurse do?
a. Contact the provider to discuss bolus dosing instead of continuous dosing.
b. Discontinue the medication and contact the provider to report these symptoms.
c. Reassure the patient that these are expected, uncomfortable side effects.
d. Request an order for dexamethasone to treat these side effects.
ANS: B
Stomatitis, GI symptoms, and palmar-plantar erythrodysesthesias are dose-limiting side effects of fluorouracil, characterized by the symptoms described. When these occur, the provider should be notified. Continuous dosing is generally less toxic than bolus dosing. Reassurance without discontinuing the medication and contacting the provider is not correct. Dexamethasone is not given to counter these effects.
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