Question

A patient with a history of receiving chest radiation as a teenager is scheduled to receive a third cycle of doxorubicin and cyclophosphamide. The nurse notes the patient's cumulative dose of doxorubicin before this cycle is 440 mg/m2. The nurse's initial response is to: a cancel the therapy. b notify the oncologist. c administer the chemotherapy. d anticipate a referral to cardiology.

Answer 1

Answer: The nurse should anticipate a referral to cardiology as Doxorubicin use is contraindicated in patients with severe myocardial insufficiency or recent (occurring within the past 4 to 6 weeks) myocardial infarction. If the cumulative doxorubicin dose exceeds 300 mg/m2 in a patient that will continue to receive therapy, increase the frequency of cardiac assessment and consider starting dexrazoxane to reduce the incidence and severity of cardiomyopathy.