# A client is scheduled to receive ifosfamide. Which actions belong in the nursing safety plan? Select exactly 4 responses.

> source: MyMerci (mymerci.kr)  
> url: https://mymerci.kr/pages/nclex_q.php?qn_id=602991&lang=en  
> language: en  
> subject: Adverse Effects/Contraindications/Interactions  
> category: PPT

## Question

A client is scheduled to receive ifosfamide. Which actions belong in the nursing safety plan? Select exactly 4 responses.

Select exactly 4 responses.

1

Report hematuria, dysuria, reduced urine output, or encephalopathy findings promptly.

2

Ignore new confusion because temporary sedation is expected.

3

Verify the prescribed mesna schedule accompanies ifosfamide.

4

Provide the prescribed extensive hydration and monitor urine output.

5

Withhold mesna when platelet count is within the reference range.

6

Monitor urinalysis, renal function, blood counts, and neurologic status.

## Explanation

Ifosfamide requires mesna and hydration for bladder protection plus surveillance for hemorrhagic cystitis, nephrotoxicity, myelosuppression, and encephalopathy.

## In-depth explanation

Quick answer
Build the regimen around mesna, hydration, urine monitoring, and neurologic surveillance.

Why this is correct
The ifosfamide label requires mesna and extensive hydration to reduce urotoxicity. Renal failure, hemorrhagic cystitis, severe marrow suppression, and encephalopathy can occur and require prompt recognition.

Easy analogy or mental picture
Shield the bladder, keep flow moving, and watch both the filtration system and the brain.

Memory hook
Ifosfamide: mesna, liters, urine, kidneys, counts, cognition.

NCLEX decision rule
Verify protective therapy before exposure and continue outcome monitoring throughout and after administration.

Why the other choices are wrong
Confusion may be serious neurotoxicity, and a normal platelet count does not remove the need for mesna.References
1DailyMed: Ifosfamide for InjectionMesna, extensive hydration, urine and renal monitoring, myelosuppression, and encephalopathy warnings

## Clinical scenario

Ifosfamide safety bundle
Verify mesna timing, hydration, urine output, urinalysis, creatinine, electrolytes, blood counts, cognition, and infusion parameters.

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