A nurse is monitoring for an infusion reaction for a client who is receiving a dose of IV amphotericin B. Which of the following findings should indicate to the nurse that the client is experiencing an acute infusion reaction?
Pedal edema.
Fever.
Dry cough.
Hyperglycemia.
The Correct Answer is B
This is because fever is a common sign of an acute infusion reaction that can occur when receiving IV amphotericin B. An acute infusion reaction is caused by the release of pro-inflammatory cytokines from the fungal cell wall disruption by amphotericin B. It usually occurs within the first hour of infusion and can be prevented by administering pre-medications such as antipyretics, antihistamines, or corticosteroids.
Choice A. Pedal edema is wrong because it is not a typical sign of an acute infusion reaction.
Pedal edema may indicate fluid overload, heart failure, or renal impairment, which are not directly related to amphotericin B infusion.
Choice C. Dry cough is wrong because it is not a typical sign of an acute infusion reaction.
Dry cough may indicate an allergic reaction, pulmonary infection, or interstitial lung disease, which are not directly related to amphotericin B infusion. Choice D. Hyperglycemia is wrong because it is not a typical sign of an acute infusion reaction.
Hyperglycemia may indicate diabetes mellitus, steroid use, or stress response, which are not directly related to amphotericin B infusion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
The correct answer is d
Choice A reason:
Administering filgrastim 12 hours after chemotherapy does not typically require an incident report. Filgrastim is often given at least 24 hours after chemotherapy to avoid the risk of increasing the toxicity of the chemotherapy agents. While the timing is closer than recommended, it does not necessarily constitute an error unless specific instructions for the timing were provided by the prescribing physician.
Choice B reason:
The medication vial sitting at room temperature for 2 hours before administration does not require an incident report. Filgrastim can be left out at room temperature for up to 24 hours before use. This is within the safe handling guidelines for the medication.
Choice C reason:
An absolute neutrophil count (ANC) of 2,500/mm³ is within the normal range, which is typically 1,500-8,000/mm³. Filgrastim is used to increase neutrophil counts in patients with low ANC due to chemotherapy. Since the ANC was not low before administration, this would not necessitate an incident report, although it may prompt a review of the necessity of the medication.
Choice D reason:
Flushing the client's IV line with dextrose 5% in water before and after the medication was administered is not the standard procedure and could potentially lead to medication errors or adverse effects. Filgrastim should be diluted in glucose 5% in water for intravenous infusion, but not used to flush the line. This deviation from the standard protocol is what necessitates an incident report.
Correct Answer is C
Explanation
Atorvastatin is a medication that belongs to a group of drugs called statins. It is used to lower blood levels of “bad” cholesterol (low-density lipoprotein, or LDL), to increase levels of “good” cholesterol (high-density lipoprotein, or HDL), and to lower triglycerides (a type of fat in the blood). The treatment has been effective if the LDL level is reduced, as high LDL levels can increase the risk of heart disease and stroke. A normal range for LDL is less than 100 mg/dL.
Choice A is wrong because urine specific gravity is a measure of how concentrated the urine is, not how much cholesterol is in the blood. A normal range for urine specific gravity is 1.005 to 1.0304.
Choice B is wrong because BUN (blood urea nitrogen) is a measure of how well the kidneys are working, not how much cholesterol is in the blood. A normal range for BUN is 7 to 20 mg/dL.
Choice D is wrong because blood glucose is a measure of how much sugar is in the blood, not how much cholesterol is in the blood.
A normal range for blood glucose is 70 to 100 mg/dL.
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