A nurse is caring for a patient with cancer who has been undergoing chemotherapy. The patient has oral mucositis as a result of the chemotherapy, and the provider has ordered palifermin (Kepivance)
Which is an appropriate nursing action when giving this drug?
a. Administering the drug as a slow IV infusion
b. Flushing the IV line with heparin before infusing the drug
c. Giving the drug within 6 hours of the chemotherapy
d. Warning the patient about the potential for distortion of taste
ANS: D
Palifermin is generally well tolerated but commonly causes reactions involving the skin and mouth, including taste distortion. The drug should be given as an IV bolus. Palifermin binds with heparin, so the IV line should not be flushed with heparin before giving palifermin. If the interval between administration of palifermin and the chemotherapeutic drugs is too short, palifermin actually may increase the severity and duration of oral mucositis; therefore, palifermin should be given 24 hours before the chemotherapeutic drugs.
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