# A nurse is administering cisplatin to a client with testicular cancer. Which nursing interventions are essential to reduce toxicity?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391864&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A nurse is administering cisplatin to a client with testicular cancer. Which nursing interventions are essential to reduce toxicity?

## Option

1. Daily ASA for kidney protection
2. Encourage minimal fluid intake to reduce kidney work
3. Aggressive IV hydration with mannitol diuresis, antiemetic prophylaxis (5-HT3 + dex + NK1), baseline and serial creatinine, electrolytes (Mg/K), and audiometry **✔ Correct answer**
4. Avoid antiemetics to monitor true GI tolerance

**Correct answer: 3**

## 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.

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