A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?
The client's absolute neutrophil count was 2,500/mm3 before the medication was administered.
The medication vial sat at room temperature for 2 hr before it was administered.
The client had chemotherapy 12 hr before the medication was administered.
The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered.
The Correct Answer is B
Choice A rationale: The client's initial neutrophil count might be within an acceptable range for filgrastim administration.
Choice B rationale: Filgrastim, a medication used to increase white blood cell count, should ideally be stored and administered as per manufacturer recommendations.
Allowing it to sit at room temperature for an extended period could affect its potency or efficacy, necessitating an incident report.
Choice C rationale: Having chemotherapy before filgrastim administration might not necessitate an incident report.
Choice D rationale: Flushing the IV line with dextrose solution is a routine practice and might not relate to the need for an incident report.
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Related Questions
Correct Answer is D
Explanation
Choice A rationale: Exophthalmos (bulging eyes) is a characteristic feature of Graves' disease and might not directly relate to the need for a lower medication dose.
Choice B rationale: Weight loss is a symptom of hyperthyroidism and might not directly indicate the need for a lower methimazole dose.
Choice C rationale: Diaphoresis (excessive sweating) can be a symptom of hyperthyroidism but might not solely indicate the need for a lower methimazole dose.
Choice D rationale: Bradycardia (abnormally slow heart rate) might indicate excessive suppression of thyroid function caused by an excessive dose of methimazole in a client with Graves' disease, warranting a lower medication dose.
Correct Answer is C
Explanation
Choice A rationale: While monitoring sodium levels is important, a level of 139 mEq/L is within the normal range and might not directly correlate with cyclosporine
administration.
Choice B rationale: Though BUN levels can indicate kidney function, a level of 18 mg/dL falls within the normal range and might not immediately indicate adverse effects related to cyclosporine.
Choice C rationale: Cyclosporine, often prescribed for rheumatoid arthritis, can impact kidney function. An elevated creatinine level (2.5 mg/dL) might signify potential kidney impairment, necessitating immediate attention from the provider to assess and manage any adverse effects of the medication on renal function.
Choice D rationale: A potassium level of 4.2 mEq/L is within normal limits and might not directly relate to potential complications due to cyclosporine therapy.
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