| Genitourinary Tract | ||
| Hemorrhagic Cystitis | Cells lining bladder are destroyed by chemotherapy (e.g., cyclophosphamide, ifosfamide).
Side effect of radiation when located in treatment field. |
Encourage increased fluid intake 24-72 hr after treatment as tolerated.
Monitor manifestations such as urgency, frequency, and hematuria. Administer cytoprotectant agent (mesna [Mesnex]) and hydration. Administer supportive care agents to manage symptoms (e.g., lavoxate [Urispas]). |
| Reproductive Dysfunction | Cells of testes or ova are damaged by therapy. | Discuss possibility with patients before treatment initiation.
Offer opportunity for sperm and ova banking before treatment for patients of childbearing age. |
| Nephrotoxicity | Direct renal cell damage from exposure to nephrotoxic agents (cisplatin and high-dose methotrexate).
Precipitation of metabolites of cell breakdown (tumor lysis syndrome [TLS]). |
Monitor BUN and serum creatinine levels.
Avoid potentiating drugs. Alkalinize the urine by adding sodium bicarbonate to IV infusion and administer allopurinol (Zyloprim) or rasburicase for TLS prevention |
Testing and Diagnosis for Venous Thromboembolism
For Everyone KEY POINTS Your doctor must perform special tests to diagnose deep vein thrombosis (DVT) and pulmonary embolism (PE). There are many conditions with
