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
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 dis-tress syndrome. Alopecia would not cause the nurse to withhold the dose. Neutropenia is ex-pected and is not at a critical level. Although this count is low, it would not prevent administra-tion of the medication. Peripheral neuropathy is expected with vinorelbine.
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