# A client on bevacizumab for metastatic colon cancer reports severe abdominal pain and bloody diarrhea. Which is the nurse's priority interpretation?

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=391869&lang=en  
> language: en  
> subject: Medical Emergencies  
> category: PA

## Question

A client on bevacizumab for metastatic colon cancer reports severe abdominal pain and bloody diarrhea. Which is the nurse's priority interpretation?

## Option

1. Switch from biologic to chemotherapy
2. Routine hemorrhoids
3. Expected GI side effect
4. Suspected GI perforation — urgent provider notification, hold bevacizumab, prepare for imaging and possible surgery; also screen for HTN, proteinuria, and thrombotic events **✔ Correct answer**

**Correct answer: 4**

## Explanation

Correct (2): Bevacizumab (anti-VEGF) impairs wound healing; boxed warnings: GI perforation, severe bleeding, thrombosis, hypertension, proteinuria, wound dehiscence. Severe abdominal pain + bloody diarrhea raises concern for perforation — urgent. (1,3) Wrong scope. (4) Treatment plan, not acute action.

## In-depth explanation

Memory Tip Bevacizumab = "Block VEGF = Block Vessels = Bleed/Block." Watch HTN, proteinuria, GI perf, wound dehiscence. Hold 4-6 weeks around surgery.

## Clinical scenario

Scenario 60-year-old male on bevacizumab 8 weeks; new severe abdominal pain, bloody diarrhea, BP 168/98.

## Key concepts

- **Bevacizumab** — Anti-VEGF; antiangiogenic; multiple boxed warnings including GI perforation.
- **Anti-angiogenic adverse effects** — HTN, proteinuria, bleeding, thrombosis, GI perforation, wound healing impairment.
- **Pre-surgical hold** — Hold bevacizumab 4-6 weeks before surgery and resume after wound healing.

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