What is a responsible practice when a patient reports a missed chemotherapy dose?

• A. Do nothing and wait for the next scheduled dose.
• B. Reschedule all future doses without assessment.
• C. Assess reason for missed dose, consult the prescriber, determine whether to administer a missed dose or reschedule, and document the decision.
• D. Administer the missed dose immediately without consulting physician.

Answer: (C)

When a patient misses a chemotherapy dose, the responsible practice is to assess the reason for the missed dose, consult the prescriber, determine whether to administer the missed dose or to reschedule within the cycle, and document the decision and plan. This approach ensures patient safety and treatment effectiveness. By identifying why the dose was missed—whether due to side effects, lab results, nonadherence, or scheduling issues—you can weigh risks and benefits in the context of the specific regimen and patient condition. Involving the prescriber ensures that any dose adjustments, timing changes, or the need for supportive measures align with the treatment plan and toxicity guidelines. Documenting the assessment, the decision, and the plan provides a clear, auditable record for future care and continuity.

Doing nothing ignores potential safety and efficacy implications. Rescheduling without assessment could disrupt the intended dose intensity or overlook a contraindication. Administering the missed dose without physician input may lead to inappropriate dosing or adverse interactions if the regimen has strict timing, cumulative toxicity, or coordination with other agents. The correct approach keeps the patient’s safety at the forefront while preserving treatment intent.