A nurse is preparing to administer topotecan IV for a client who has metastatic ovarian cancer. Which of the following medications should the nurse expect to administer to control the adverse effects of topotecan?

Choice A rationale Insulin lispro is a rapid-acting insulin used to manage hyperglycemia in clients with diabetes mellitus. Its primary mechanism involves facilitating glucose uptake into cells and inhibiting hepatic glucose production. It does not directly mitigate the adverse effects, such as myelosuppression and gastrointestinal issues, associated with topotecan, a topoisomerase I inhibitor used in chemotherapy. Choice B rationale Granisetron is a serotonin 5-HT3 receptor antagonist, primarily used to prevent nausea and vomiting induced by chemotherapy. It works by blocking serotonin's action on vagal nerve terminals and in the chemoreceptor trigger zone in the brainstem. This action effectively controls a common and distressing adverse effect of topotecan, thereby improving client comfort and compliance. Choice C rationale Magnesium sulfate is an electrolyte replacement and smooth muscle relaxant. It is used in conditions like pre-eclampsia, eclampsia, and hypomagnesemia. Its physiological effects involve stabilizing neuronal excitability and reducing uterine contractions. It is not indicated for the management of topotecan's adverse effects, which predominantly involve myelosuppression and gastrointestinal toxicity. Choice D rationale Prednisone is a corticosteroid with potent anti-inflammatory and immunosuppressive properties. It is used to treat various conditions, including autoimmune disorders, allergic reactions, and some cancers. While it can reduce inflammation, it does not specifically target the common adverse effects of topotecan, such as myelosuppression and gastrointestinal disturbances.