hard · NCLEX-RN pharmacology
The oncology clinic nurse is providing telephone triage for a 62-year-old client with colorectal cancer who is on day 10 of a 14-day capecitabine cycle (1,250 mg/m2 orally twice daily). The client reports new painful redness, swelling, and tingling that interfere with walking and grasping objects on the palms of both hands and the soles of both feet. Which instructions should the nurse provide? Select all that apply.
- Soak the hands and feet in hot water with Epsom salts twice daily to soothe the tingling sensations.
- Increase the scheduled daily fluid intake to 3 liters to help flush the drug metabolites from the skin tissue.
- Do not restart capecitabine until the oncology provider directs; expect restart only after improvement to grade 0 or 1, potentially at a reduced dose.
- Hold the capecitabine doses immediately and notify the oncology provider for further instructions.
- Apply a thick layer of a petroleum-based emollient to the hands and feet and wear tight-fitting cotton gloves.
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