A nurse accidently administers the medication metformin instead of metoprolol to a client. Which of the following actions should the nurse take?

A. Bradycardia:
Incorrect Explanation: Bradycardia (slow heart rate) is not a common adverse effect of phenytoin.
Explanation: Phenytoin primarily affects the central nervous system and is not known to cause significant cardiovascular effects like bradycardia.
B. Red man syndrome:
Incorrect Explanation: Red man syndrome is associated with some antibiotics, not phenytoin.
Explanation: Red man syndrome, characterized by redness and flushing of the skin, is primarily associated with certain antibiotics like vancomycin and is not a recognized adverse effect of phenytoin.
C. Hypoglycemia:
Incorrect Explanation: Hypoglycemia is not a common adverse effect of phenytoin.
Explanation: Phenytoin does not have a direct impact on blood glucose levels, so hypoglycemia is not a typical adverse effect.
D. Hypotension:
Correct Answer: Hypotension (low blood pressure) is an adverse effect that the nurse should identify as a potential concern with phenytoin administration.
Explanation: Phenytoin, especially when administered rapidly as an IV bolus, can lead to hypotension as one of its adverse effects. Monitoring blood pressure during and after administration is important.

A. The client's absolute neutrophil count was 2.500/mm³ before the medication was administered:
Incorrect Explanation: This is a normal data point that does not suggest an adverse event or error.
Explanation: An absolute neutrophil count of 2.500/mm³ is within the normal range, and there is no indication of a problem related to the administration of filgrastim based on this information.
B. The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered:
Incorrect Explanation: Routine flushing of the IV line with appropriate solutions is a standard practice and not indicative of an incident.
Explanation: Flushing the IV line with dextrose 5% in water before and after medication administration is a routine procedure to maintain line patency and prevent interactions between medications.
C. The client had chemotherapy 12 hours before the medication was administered:
Incorrect Explanation: The timing of chemotherapy does not necessarily indicate an incident.
Explanation: Knowing the timing of chemotherapy is important for overall patient care, but it doesn't necessarily indicate an incident or error related to the administration of filgrastim.
D. The medication vial sat at room temperature for 2 hours before it was administered:
Correct Answer: This is the data point that should lead to filing an incident report.
Explanation: Many medications, including filgrastim, have specific storage requirements to ensure their effectiveness and safety. Allowing a medication vial to sit at room temperature for an extended period can compromise its stability and effectiveness. This situation should be reported as it involves a potential deviation from proper medication storage and handling procedures.