A nurse is administering doxorubicin (a vesicant chemotherapy agent) through a peripheral IV when the patient reports burning at the IV site. The nurse notes swelling and erythema. Which actions are appropriate? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Vesicant extravasation requires immediate action: STOP infusion, KEEP catheter for residual aspiration, notify provider STAT, give antidote per protocol (dexrazoxane for anthracyclines via opposite limb + topical DMSO; hyaluronidase for vincas), and apply temperature per drug class — COLD for anthracyclines (vasoconstriction limits spread), WARM for vinca alkaloids (vasodilation aids dispersion). Choice 1 is dangerous — continuing infusion worsens tissue damage and necrosis.
Anthracycline (doxorubicin) extravasation = COLD compress + dexrazoxane in OPPOSITE limb. Vinca alkaloid (vincristine) extravasation = WARM compress + hyaluronidase SC at site. Memorize: cold for anthracyclines (red drugs), warm for vincas (clear drugs). Tissue necrosis can occur within hours; central line preferred for vesicants.
Patient receiving doxorubicin through a peripheral IV develops burning, swelling, and erythema at the IV site — suspected vesicant extravasation. The unit follows oncology extravasation protocol.