A nurse is collecting a medication history from the parent of a preschooler who comes to the clinic for routine immunizations. For which of the following findings should the nurse withhold the varicella immunization?

A. Hypertension. Filgrastim, a granulocyte colony-stimulating factor (G-CSF), primarily stimulates white blood cell production. While minor blood pressure fluctuations can occur, hypertension is not a common or significant adverse effect. Monitoring blood pressure is important, but sustained hypertension is not expected.

B. Fluid retention. Filgrastim does not typically cause significant fluid retention. Medications such as corticosteroids or certain chemotherapeutic agents are more likely to lead to fluid overload. While rare cases of capillary leak syndrome have been reported, general fluid retention is not a primary concern.

C. Bone pain. Bone pain is the most common adverse effect of filgrastim. The medication stimulates bone marrow activity, leading to increased production of neutrophils, which can cause discomfort in bones, particularly in long bones such as the femur and sternum. Pain is usually mild to moderate and can be managed with acetaminophen or NSAIDs if appropriate.

D. Hypokalemia. Filgrastim does not have a direct effect on potassium levels. Electrolyte imbalances are more commonly associated with diuretics, corticosteroids, or chemotherapy. Clients on filgrastim typically do not require routine potassium monitoring unless other risk factors are present.

A. Oatmeal. Oatmeal is a healthy carbohydrate and fiber source, but it is not a significant source of potassium, which is essential for clients taking furosemide. While beneficial for overall health, oatmeal will not help counteract potassium loss caused by diuretic therapy.

B. Baked potatoes. Baked potatoes are rich in potassium, which is frequently lost due to furosemide’s potassium-wasting effects. Furosemide is a loop diuretic that increases urine output and depletes electrolytes, particularly potassium, which can lead to hypokalemia (low potassium levels). To help maintain electrolyte balance, clients should consume potassium-rich foods like potatoes, bananas, oranges, and spinach.

C. Brown rice. Brown rice is a good source of fiber and complex carbohydrates, but it contains only small amounts of potassium. While it provides sustained energy, it does not significantly contribute to potassium replacement, making it less beneficial for clients on furosemide.

D. Eggs. Eggs are high in protein and essential nutrients but are not a significant source of potassium. While eggs are beneficial for overall health, they do not help replenish potassium lost due to diuretic therapy.