Challenge Your Exam Readiness With Our Free AOCNP Practice Questions

Anthracyclines are DNA-binding vesicants; extravasation can cause progressive tissue necrosis. The correct response is to stop the infusion, leave the catheter in place to aspirate residual drug, apply cold compresses (to limit dispersion), photograph/measure the area, and rapidly initiate dexrazoxane—an approved antidote that chelates intracellular iron, reducing free-radical damage—ideally within 6 hours (given IV on days 1–3). Warm compresses and hyaluronidase (Option A) are appropriate for non–DNA-binding vesicants like vinca alkaloids, not anthracyclines. Removing the catheter and massaging (Option C) can spread the drug into tissues. Observation alone (Option D) risks deep injury. APRNs should ensure extravasation kits and dexrazoxane access, educate staff on drug-specific algorithms, consult plastics if extensive injury, and transition vesicant administration to central access when feasible. Documentation with photos and patient instructions for delayed ulceration are essential.