Cisplatin can cause cumulative nephrotoxicity, renal electrolyte wasting, severe nausea and vomiting, and ototoxicity. Adequate hydration, highly effective antiemetic prophylaxis, and baseline and serial monitoring of renal function, magnesium, potassium, and hearing are appropriate. Fluid restriction, delayed antiemetics, and osmotic diuresis without hydration increase risk.
In-depth explanation
Clinical reasoning
Cisplatin injury commonly affects the renal tubules and cochlea and can cause substantial magnesium and potassium losses. It is also highly emetogenic.
Decision rule
Before and during cisplatin, protect renal perfusion with the prescribed hydration plan, prevent nausea before it starts, and trend renal function, electrolytes, and hearing.
For study reference only. Always follow current clinical guidelines and your institution’s protocols.