Which finding represents a potential complication requiring immediate action during chemotherapy administration?

• A. Extravasation at IV site
• B. Alopecia
• C. Anemia
• D. Weight loss

Answer: (A)

Extravasation of a vesicant chemotherapy drug at the IV site is an immediate emergency because the leaked drug can rapidly damage surrounding tissue and cause tissue necrosis. The key to safety is rapid intervention: stop the infusion right away and assess for signs of infiltration such as increasing pain, burning, swelling, or blanching at the site. If possible, without dislodging the access, stop the drug, disconnect the IV line, and attempt to aspirate any residual drug from the catheter to limit spread. Do not flush the line. Notify the prescriber and oncology team immediately so they can determine the appropriate antidote or treatment protocol and administer it within recommended timeframes. Elevate the limb and apply the appropriate local treatment per protocol (sometimes cold or warm applications, depending on the drug), and monitor the area closely. Document the event and follow through with subsequent orders.

Alopecia, anemia, and weight loss are common side effects of chemotherapy, but they do not require immediate action during administration like extravasation does.