|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