. A nurse is preparing to administer filgrastim 5 mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) _mcg

A) Give diphenhydramine IM: Diphenhydramine is an antihistamine that can help alleviate allergic symptoms such as itching, hives, and mild allergic reactions. However, in the case of an anaphylactic reaction, which is a severe and potentially life-threatening allergic reaction, diphenhydramine alone may not be sufficient. While it can be administered as an adjunctive therapy, it is not the primary intervention for anaphylaxis. Therefore, giving diphenhydramine IM should not be the next action after stopping the medication infusion.

B) Elevate the client's legs and feet: Elevating the client's legs and feet is a supportive measure that can help improve venous return to the heart and mitigate symptoms of hypotension. However, in the context of an anaphylactic reaction, the priority is to address airway compromise and cardiovascular collapse, as these are life-threatening complications. Elevating the legs and feet may be considered after administering epinephrine and ensuring stabilization of the client's airway, breathing, and circulation.

C) Replace the infusion with 0.9% sodium chloride: While stopping the infusion of the offending medication is essential in managing an anaphylactic reaction, replacing it with 0.9% sodium chloride solution alone does not address the systemic effects of anaphylaxis. The priority is to administer medications such as epinephrine to reverse the allergic response and stabilize the client's condition. Therefore, replacing the infusion with 0.9% sodium chloride should not be the next action after stopping the medication infusion.

D) Administer epinephrine IM: Epinephrine is the first-line treatment for anaphylaxis due to its rapid onset of action and ability to reverse bronchoconstriction, vasodilation, and increased vascular permeability associated with the allergic reaction. Administering epinephrine IM helps counteract the severe manifestations of anaphylaxis, including respiratory distress and hypotension. Therefore, it is the most appropriate next action after stopping the medication infusion and assessing the client's respiratory status.

A) Ask another nurse if they are aware of potential interactions: Relying solely on another nurse's awareness of potential interactions is’not a comprehensive or reliable approach. Nurses may have varying levels of knowledge about medication interactions, and it's important to consult verified sources ’or accurate information.

B) Check the client's medical record for medication and food’interactions: While the client's medical record may contain information’about their current medications, it may not provide detailed information about potential interactions with specific foods or other medications. Additionally, relying solely on the medical record may not capture recent changes in medication or dietary intake.

C) Consult a drug reference guide for possible interactions: This is the correct action. Drug reference guides provide comprehensive information about medications, including potential interactions with other drugs and food. Nurses can access reliable drug reference guides to ensure they have accurate information before administering medications.

D) Have the client take the medication on an empty stomach to avoid interactions: Instructing the client to take medication on an empty stomach without knowledge of specific interactions could be inappropriate and potentially harmful. Some medications require administration with food to enhance absorption or reduce gastrointestinal side effects. It's essential to consult reliable sources ’o determine the appropriate administration instructions for each medication.