A client is receiving IV doxorubicin hydrochloride for cancer treatment. The nurse notes swelling and pain at the IV site. What action should be prioritized?

• A. Stopping the administration of the drug immediately
• B. Notifying the client's physician
• C. Continuing the infusion but decreasing the rate
• D. Applying a warm compress to the infusion site

Answer: (A)

Doxorubicin is a vesicant, meaning if it leaks into the tissue it can cause severe local tissue injury. When swelling and pain appear at the IV site, the priority is to stop the infusion immediately to halt further leakage of the drug into surrounding tissue. This immediate action minimizes the amount of drug that can cause damage and buys time for appropriate management, such as evaluating the site, removing the cannula if needed, and notifying the physician for orders like antidotes or further treatment. Delaying stopping the infusion or continuing at a slower rate would allow more drug to infiltrate tissue, increasing the risk of necrosis. A warm compress could potentially promote spread of the drug in tissue, which is not the desired response for this vesicant injury. After stopping, one would typically assess the site and follow physician-directed steps, including possible antidotal therapy and specific local care.