The oncology nurse reviews a follow-up note for a client rec… | MyMerci
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Medication Administration

The oncology nurse reviews a follow-up note for a client receiving cyclophosphamide. Which findings require immediate follow-up? Highlight the findings associated with possible hemorrhagic cystitis.

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Nurses' Notes 1410: The client received the third outpatient cyclophosphamide treatment two days ago. The morning weight is unchanged from the previous treatment visit. The client reports mild fatigue after walking to the kitchen. The oral mucosa is moist, and the small mouth ulcer from last week has healed. At 1330, the client noticed red urine with two small clots in the toilet. Appetite improved after the prescribed antiemetic was taken. The client says that urine was clear yellow earlier this week. During the call, the client describes suprapubic burning that becomes worse during urination. The temperature is 37.1 °C. The home pulse reading is similar to the usual resting value. The client reports drinking the fluids listed in the treatment plan. A routine blood count is scheduled for tomorrow morning at the infusion center. Since noon, the client has voided small amounts six times with a strong urge. The client denies flank trauma or a recent urinary procedure. The bowel movement today was soft and brown. The client can state when the next oncology appointment is scheduled. No nosebleed or gum bleeding is reported. The nurse reviews the medication list and confirms no new anticoagulant was started.
Nurses' Notes 1410: The client received the third outpatient cyclophosphamide treatment two days ago. The morning weight is unchanged from the previous treatment visit. The client reports mild fatigue after walking to the kitchen. The oral mucosa is moist, and the small mouth ulcer from last week has healed. At 1330, the client noticed red urine with two small clots in the toilet. Appetite improved after the prescribed antiemetic was taken. The client says that urine was clear yellow earlier this week. During the call, the client describes suprapubic burning that becomes worse during urination. The temperature is 37.1 °C. The home pulse reading is similar to the usual resting value. The client reports drinking the fluids listed in the treatment plan. A routine blood count is scheduled for tomorrow morning at the infusion center. Since noon, the client has voided small amounts six times with a strong urge. The client denies flank trauma or a recent urinary procedure. The bowel movement today was soft and brown. The client can state when the next oncology appointment is scheduled. No nosebleed or gum bleeding is reported. The nurse reviews the medication list and confirms no new anticoagulant was started.
Explanation
Visible blood in urine, painful suprapubic burning with urination, and frequent small voids require immediate follow-up. Cyclophosphamide metabolites can injure the bladder lining and cause hemorrhagic cystitis.
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