How should a nurse respond to suspected infusion reaction during chemotherapy infusion?

• A. Stop the infusion, assess airway and circulation, administer prescribed reaction medications, notify physician, and decide whether to restart at slower rate or discontinue.
• B. Increase the infusion rate to finish quickly.
• C. Ignore symptoms if they subside.
• D. Stop infusion and discontinue all care.

Answer: (A)

The key idea is to respond to an infusion reaction with immediate actions that protect the patient while initiating medical management. The first step is to stop the chemotherapy infusion right away to prevent further exposure to the offending agent and potential worsening of the reaction. Then you assess the patient’s airway, breathing, and circulation, checking vital signs and looking for signs of airway compromise, wheezing, hypotension, or other distress. This rapid assessment guides the next steps—whether the patient can maintain a stable airway and adequate perfusion or needs urgent intervention.

Administering prescribed reaction medications is essential. Depending on the reaction’s severity, this can include antihistamines, corticosteroids, bronchodilators, or, in cases of suspected anaphylaxis, epinephrine per protocol. Providing oxygen and securing the airway as needed are critical supports during any suspected severe reaction. After initiating treatment, you must notify the physician promptly so they can determine the appropriate next steps for ongoing care and chemotherapy plans.

A decision is then made about whether to restart the infusion at a slower rate or discontinue the medication altogether, based on how the patient responds to treatment and the physician’s guidance. Restarting at a slower rate may be considered only after symptoms are controlled and the clinician agrees it’s safe; otherwise, discontinuation of the infusion is indicated and an alternate plan is pursued.

Increasing the infusion rate would be dangerous and could worsen the reaction. Ignoring symptoms or treating the situation as if nothing happened is unsafe and inappropriate, and stopping the infusion does not justify discontinuing all care—the patient still needs monitoring and treatment as ordered.