Final answer:
The nurse's initial action should be to contact the physician immediately when a patient receiving vincristine reports not feeling the ground with the bottom of their feet, indicating possible neurotoxicity. Administering further chemotherapy without physician consultation could worsen the patient's condition.
Step-by-step explanation:
A patient scheduled to receive a sixth dose of vincristine reporting an inability to feel the ground with the soles of their feet is describing a symptom of peripheral neuropathy, a known side effect of vincristine and many other chemotherapeutic agents. This symptom should be taken seriously, as it indicates possible neurotoxicity, which could become severe if the medication is continued. The initial action of the nurse in this case should be to contact the physician immediately before administering further chemotherapy to report the new symptom and determine the best course of action. While it is important to document the patient's report thoroughly, the immediate safety and well-being of the patient take precedence over documentation and administering the medication, which could exacerbate the condition. It's necessary to confer with the doctor to assess whether the benefit of continuing treatment outweighs the risks associated with the side effects, and to possibly adjust the treatment regimen accordingly.