A nurse is assessing a client who has hypertension and has started taking lisinopril. Which of the following findings should the nurse report to the provider immediately?

A. The client had a decreased neutrophil count before the medication was administered: This finding may be expected in a client undergoing cytotoxic chemotherapy and receiving filgrastim to stimulate neutrophil production. It is not an indication for an incident report.
B. The client had chemotherapy 12 hr before the medication was administered: The timing of chemotherapy administration is not typically a reason to complete an incident report unless it conflicts with specific medication guidelines or protocols.
C. The vial was out of the refrigerator for 2 hr before the medication was administered:

Filgrastim should be stored in the refrigerator and protected from light. Allowing the medication vial to be out of the refrigerator for an extended period may compromise its stability and effectiveness, potentially leading to adverse effects or reduced efficacy. Therefore, this finding warrants completion of an incident report.
D. The client reported feeling nauseous after the medication was administered: Nausea is a known side effect of filgrastim and is not typically an indication for completing an incident report unless it is severe or persistent and requires intervention.

A. Constipation: Constipation is not a commonly reported adverse effect of clopidogrel.

Therefore, it is not necessary to instruct the client to monitor and report constipation as an adverse effect.
B. Weight loss: Weight loss is not a commonly reported adverse effect of clopidogrel. Therefore, it is not necessary to instruct the client to monitor and report weight loss as an adverse effect.
C. Bruising: Clopidogrel is an antiplatelet medication that inhibits platelet aggregation.

Therefore, one of the potential adverse effects is an increased risk of bleeding, which can

manifest as easy bruising or prolonged bleeding from minor injuries. Instructing the client to monitor and report bruising is important for early detection of bleeding complications.
D. Blurred vision: Blurred vision is not a commonly reported adverse effect of clopidogrel.

Therefore, it is not necessary to instruct the client to monitor and report blurred vision as an adverse effect.