Mostly IV; dosing based on \text{BSA (m}^2) & organ function.
Extravasation (vesicants)
S/S: pain, erythema, blistering, necrosis.
Most important nursing intervention = prevention (use CVAD, verify patency, frequent assessment; immediately stop infusion if suspected).
PPE for staff: eye shield, mask, chemo-rated double gloves, gown, shoe covers; safe handling of excreta 48\text{–}72 h.
Radiation Therapy
Mechanism: ionizing radiation damages DNA → cell death.
Dosing terms
Exposure: amount delivered.
Absorbed dose: \text{Gray (Gy)} – energy absorbed per unit mass.
Delivery
Teletherapy (external beam): patient not radioactive.
Brachytherapy (internal, sealed or unsealed sources)
Examples: radioactive iodine-131 for thyroid; hepatic Y-90 microspheres; intracavitary Cs-137 for cervical cancer.
Nursing considerations for brachytherapy
Principle ALARA: As Low As Reasonably Achievable → minimize time, maximize distance, use shielding.
Wear film badge/dosimeter; lead apron; cluster care; no pregnant staff/visitors; limit visitation <30 \text{min}/day, \ge 6 \text{ft} away.
Acute skin reactions: follow evidence-based skin care (no lotion/alcohol on site unless prescribed; lukewarm water; protect from sun; avoid tight clothing). Do not remove positioning tattoos.