A nurse is administering cisplatin to a client with testicul… | MyMerci
Medical EmergenciesPA
Question
A nurse is administering cisplatin to a client with testicular cancer. Which nursing interventions are essential to reduce toxicity?
1Daily ASA for kidney protection
2Encourage minimal fluid intake to reduce kidney work
3Aggressive IV hydration with mannitol diuresis, antiemetic prophylaxis (5-HT3 + dex + NK1), baseline and serial creatinine, electrolytes (Mg/K), and audiometry✓ Correct answer
4Avoid antiemetics to monitor true GI tolerance
Explanation
Correct (2): Cisplatin is highly nephrotoxic, ototoxic, and emetogenic. Standard practice: aggressive hydration ± mannitol diuresis, baseline/serial Cr and electrolytes (especially Mg, K), audiometry, and triple antiemetic (5-HT3 + dexamethasone + NK1 antagonist). (1,3,4) All harmful.
In-depth explanation
Memory Tip Cisplatin = "Cis-PLATIN damages PLATs (kidneys flat)" + ototoxic + emetogenic. Amifostine cytoprotectant in some regimens.
Clinical scenario
Scenario 38-year-old male starting cisplatin for testicular cancer.
Key concepts
Cisplatin — Platinum chemotherapy; nephro-, oto-, and neurotoxic; severely emetogenic.
Aggressive hydration — Pre-, during, and post-cisplatin to reduce nephrotoxicity.
Audiometry — Baseline and serial hearing test for cisplatin ototoxicity.