During peripheral doxorubicin infusion, a client develops new burning and stinging, localized erythema, a 3 cm area of swelling, and a high-pressure pump alarm at the IV site. Blood return remains present on gentle aspiration; temperature is 36.9 C and the client has no dyspnea. Place the actions in the safest order after recognizing suspected doxorubicin extravasation.
Ordered Response
Choose your responses, then check the answer.
Explanation
The sequence first stops exposure, then aspirates through the retained line, activates the protocol, provides local care, and delivers time-sensitive dexrazoxane through separate access.
Quick answer Use the sequence stop → aspirate → activate → cool/elevate → antidote.
Why this is correct The earliest actions limit tissue exposure. Documentation and protocol activation follow without delaying care, and dexrazoxane is administered as soon as possible within the labeled 6-hour window.
Easy analogy or mental picture Turn off the leak before calling the repair crew; then contain it while the definitive response arrives.
Memory hook Exposure control comes before documentation and definitive treatment.
NCLEX decision rule Order actions by immediate harm prevention, recovery of residual drug, team activation, local care, and time-sensitive therapy.
Why the other choices are wrong Giving the antidote before stopping exposure or flushing first reverses the safety sequence and can increase injury.
References
1DailyMed: Doxorubicin Extravasation ManagementAspiration, no flushing, ice, elevation, and dexrazoxane consideration
2FDA: Totect Prescribing InformationAnthracycline extravasation treatment within 6 hours and renal dose modification
3ONS/ASCO Antineoplastic Extravasation GuidelineEvidence-based antidote, thermal care, and escalation framework
Anthracycline extravasation action sequenceOrder exposure control, aspiration, protocol activation, local care, and prescribed dexrazoxane without letting documentation delay the first protective actions.