A patient diagnosed with multiple myeloma was treated with cyclophosphamide. Which of the following interventions should be included in the nursing care plan?

Encourage the patient to void every two to three hours to prevent hemorrhagic cystitis.


• It is very important for the nurse to encourage the patient to empty his bladder every two to three hours because if the metabolites of cyclophosphamide accumulate in the bladder, they can irritate the bladder wall capillaries and lead to hemorrhagic cystitis.

• In addition to monitoring the BUN and creatinine before giving cyclophosphamide, it is important for the nurse to promote hydration of at least 3 liters per day and frequent voiding.

• High-flow oxygen therapy is insufficient in preventing interstitial pneumonitis which is a rare sign of pulmonary toxicity. Ice caps are not recommended for prevention of alopecia. Antiemetic therapy is not indicated for 7-10 days.

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