What type of adverse effect can result from cyclophosphamide if hydration is not maintained?

Cyclophosphamide is an alkylating agent commonly used in chemotherapy, and its administration can lead to several potential adverse effects. One of the most significant risks associated with cyclophosphamide is hemorrhagic cystitis, particularly if hydration is not adequately maintained.

This condition occurs when the bladder lining becomes irritated and inflamed, often due to the accumulation of toxic metabolites of cyclophosphamide, such as acrolein, which can lead to bleeding within the bladder. Maintaining proper hydration helps to dilute these toxic metabolites and promotes their excretion, reducing the risk of bladder irritation and hemorrhagic cystitis. Therefore, ensuring adequate fluid intake is a crucial nursing intervention to prevent this specific adverse effect.

In contrast, the other choices present potential issues associated with cyclophosphamide, but they are not directly related to the lack of hydration. Severe dehydration may occur due to other factors, cardiac arrhythmias could be influenced by electrolyte imbalances rather than fluid status alone, and thrombocytopenia is a common side effect of chemotherapy but not directly linked to hydration levels. Thus, hemorrhagic cystitis is the prime concern when considering the importance of hydration during cyclophosphamide treatment.