You are giving Doxorubicin peripherally IV push and based on the patient's complaints and loss of blood return, you suspect that the Doxorubicin has extravasated. Your immediate nursing intervention will involve:

• A. SLAPP: Stop the infusion, leave the needle, aspirate as much drug as possible, pull the needle, provider notification
• B. SLAPP: Slow the infusion, leave the needle, attempt to flush, push remainder of the flush into the vein, pull the needle
• C. STOP: Stop the infusion, treat the site, oncology team notification, provide follow up
• D. STOP: Slow the infusion, treat the symptoms, oncology team notification, provide follow up

Answer: (A)

The key idea is managing a vesicant extravasation quickly to minimize tissue damage. The immediate action is to stop the infusion to halt further leakage, but the catheter should be left in place so the nurse can aspirate any extravasated drug from the tissue through the cannula. After aspirating as much drug as possible, the needle is removed and the provider is notified so antidote therapy (such as dexrazoxane for doxorubicin) and further treatment can be started per protocol. Flushing the line or slowing the infusion would risk spreading the drug or delaying proper care, and attempting to push the remaining solution into the vein is contraindicated.