Assessment

• ECG, pulse, and blood pressure should be monitored before and periodically throughout therapy

• Assess lungs periodically throughout therapy. Notify physician or other health care professional if cough, wheezing, or shortness of breath occurs. Pulmonary side effects usually occur after 3–18 wk of therapy and may be fatal. Chest x-rays should also be evaluated if signs of pulmonary complications occur

• CBC and WBC with differential and platelet counts should be monitored weekly during the first 3 mo of therapy and frequently thereafter. Blood counts should be performed promptly if patient develops signs of infection (fever, chills, sore throat, stomatitis), bleeding, or bruising. Leukopenia, agranulocytosis, and thrombocytopenia usually occur after 2–12 wk of therapy and return to normal 1 mo after discontinuation

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