An elderly client is diagnosed with ovarian cancer. She has surgery followed by chemotherapy with a fluorouracil (Adrucil) IV. What should the nurse do if she notices crystals and cloudiness in the IV medication? A. Discard the solution and order a new bag B. Warm the solution C. Continue the infusion and document the finding D. Discontinue the medication

The first step in this exercise is to understand the situation. An elderly patient is being treated with chemotherapy using fluorouracil (Adrucil) IV, and crystals or cloudiness is observed in the IV medication. This is an unusual occurrence, and the nurse must determine the correct course of action to provide the best possible care for the patient while also adhering to safety protocols for handling chemotherapy medications.

When a medication appears unusual or different from its intended appearance, this can be due to various factors, including contamination, improper storage, or incorrect preparation of the medication. In the case of fluorouracil, one possible cause of cloudiness or crystallization in the IV solution could be a change in temperature that causes the drug to precipitate.

Now, we need to consider the risks and benefits associated with each of the given options: A) Discarding the solution and ordering a new bag: This option ensures that the patient is given medication without unusual appearance and eliminates any potential risk posed by a contaminated or defective solution. However, it might lead to delays in the administration of chemotherapy. B) Warming the solution: Warming the solution may help dissolve crystals or eliminate cloudiness, but without knowing the exact cause of the unusual appearance, it may not be appropriate to administer the medication in this state. C) Continuing the infusion and documenting the finding: This option does not directly address the issue and risks administering a potentially compromised medication to the patient. D) Discontinuing the medication: This ensures that a potentially harmful solution is not administered to the patient. However, it delays treatment and requires further evaluation and preparation of new medication.

Based on the assessment of risks and benefits, the most appropriate action for the nurse to take in this situation is option A) to discard the solution and order a new bag. This ensures the safety of the patient and adherence to proper protocols for handling chemotherapy medications. Additionally, documenting the finding is essential to keep track of any issues that may arise during the course of treatment.