What instruction should the nurse provide to a client prescribed cyclophosphamide for breast cancer?

Increasing fluid intake to 2000 mL to 3000 mL per day is an important instruction for clients prescribed cyclophosphamide, particularly for those undergoing treatment for breast cancer. Cyclophosphamide is an alkylating agent that can lead to potential toxicity in the bladder, primarily causing hemorrhagic cystitis. This occurs due to the accumulation of toxic metabolites (acrolein) in the bladder.

By encouraging the client to maintain high fluid intake, the nurse helps dilute these metabolites and promotes more frequent urination, which can decrease the risk of bladder irritation and damage. This hydration strategy is critical in managing side effects associated with cyclophosphamide therapy and ensuring safer excretion of the drug.

Clients may not need specific dietary restrictions regarding protein or sodium unless they have particular renal concerns. While taking medication with food can be a general guideline for minimizing gastrointestinal discomfort, in this context, the focus on hydration is essential due to the specific side effects associated with cyclophosphamide treatment.