A nurse is reviewing the laboratory data of a client who is receiving filgrastim. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the treatment?

INR

BUN

WBC count

Potassium level

Answer and Explanation

The Correct Answer is C

Choice A Reason:
INR (International Normalized Ratio) is incorrect. INR is a measurement used to monitor the effects of anticoagulants like warfarin. It assesses the blood's ability to clot. Filgrastim does not directly affect INR levels, so monitoring INR would not provide information about the effectiveness of filgrastim in stimulating white blood cell production.
Choice B Reason:
BUN (Blood Urea Nitrogen) is incorrect. BUN levels primarily indicate kidney function and hydration status. They are not directly influenced by filgrastim treatment. Monitoring BUN is essential for assessing kidney function but does not reflect the effectiveness of filgrastim therapy in increasing white blood cell counts.
Choice C Reason:
WBC count is correct. Filgrastim is a medication that stimulates the production of white blood cells (WBCs), particularly neutrophils. Therefore, the key laboratory value to monitor for assessing the effectiveness of filgrastim therapy is the WBC count. An increase in the WBC count, particularly in the neutrophil count, signifies the intended therapeutic effect of filgrastim in boosting the immune system's response by increasing the production of these infection-fighting cells.
Choice D Reason:
Potassium level is incorrect. Potassium levels are crucial for heart and muscle function. While certain medications might affect potassium levels, filgrastim's primary action is on stimulating white blood cell production and does not directly impact potassium levels. Monitoring potassium levels is essential for overall health but does not specifically indicate the effectiveness of filgrastim treatment.

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Correct Answer is C

Explanation

Choice A Reason:
"Limit your sodium intake." Is incorrect. Sodium restriction might be appropriate for some cardiovascular or renal conditions, but it is not specifically related to theophylline use.
Choice B Reason:
"Restrict milk products." is incorrect. Restricting milk products is not a necessary dietary consideration for theophylline. However, consuming high-fat dairy products may delay the absorption of theophylline, potentially affecting its effectiveness.
Choice C Reason:
"Avoid caffeinated beverages." Is correct. Theophylline is a bronchodilator used to treat respiratory conditions like asthma or chronic obstructive pulmonary disease (COPD). It belongs to the class of methylxanthine medications and acts similarly to caffeine. Consuming additional caffeine through beverages like coffee, tea, or certain sodas can increase the risk of adverse effects associated with theophylline, such as increased heart rate or nervousness. Hence, avoiding caffeinated beverages is advisable to minimize the risk of exacerbating these effects.
Choice D Reason:
"Take the medication with meals." Taking theophylline with or without meals is typically acceptable, but it's essential to maintain consistency in timing and avoid significant changes in dietary habits that might affect its absorption or metabolism.

A. Apply the patch to a hairless area of the skin. B. Apply a 4x4 dressing over the patch. C. Apply the patch to the same site every 24 hr. D. Apply the patch to a bony prominence on the chest.

Correct Answer is A

Explanation

Choice A Reason:
Apply the patch to a hairless area of the skin is correct. Nitroglycerin patches should be applied to a clean, hairless area of the skin to ensure proper absorption of the medication. Hair can interfere with the patch's adherence and the absorption of nitroglycerin into the bloodstream. The site chosen should be rotated to prevent skin irritation or tolerance development. Commonly used areas include the chest, upper arms, or torso, but it's important to follow specific instructions provided by the healthcare provider.
Choice B Reason:
Apply a 4x4 dressing over the patch is incorrect. Covering the nitroglycerin patch with a dressing may interfere with its absorption and effectiveness. These patches are designed to be applied directly to the skin without covering.
Choice C Reason:
Apply the patch to the same site every 24 hr is incorrect. Repeatedly applying the patch to the same site increases the risk of skin irritation or tolerance to the medication. It's crucial to rotate patch sites to avoid these issues.
Choice D Reason:
Apply the patch to a bony prominence on the chest is incorrect. Nitroglycerin patches should not be placed on bony prominences because these areas can be uncomfortable and may not provide optimal absorption. Instead, they are typically applied to relatively flat, hairless areas of the skin.

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A nurse is reviewing the laboratory data of a client who is receiving filgrastim. Which of the following laboratory values should the nurse monitor to evaluate the effectiveness of the treatment?

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