When administering cyclophosphamide, what should be monitored to prevent complications?

Monitoring hydration status is crucial when administering cyclophosphamide because this chemotherapy agent has a well-documented risk of causing hemorrhagic cystitis, which is an inflammation of the bladder that can lead to bleeding. Cyclophosphamide is metabolized in the liver to form toxic metabolites, which are then excreted by the kidneys. If the patient is not adequately hydrated, these metabolites can irritate the bladder lining, increasing the risk of complications.

By ensuring proper hydration, the urine becomes more dilute, which helps to minimize the contact of these toxic metabolites with the bladder wall, thereby reducing the risk of cystitis. In addition to hydration, it may also be important to encourage regular voiding to further minimize toxicity.

Monitoring electrolyte levels, liver function, and hemoglobin are certainly important in the overall management of a patient receiving chemotherapy, but they do not specifically address the immediate complication associated with cyclophosphamide related to bladder toxicity. Therefore, the most critical parameter in this context is hydration status.