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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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale: The wrist might not be the optimal site for IV catheter placement following a mastectomy due to potential limitations in venous access and increased risk of complications.
Choice B rationale: The most proximal site is not a specific location and may vary depending on the client's condition and anatomy.
Choice C rationale: The nurse should also avoid placing a catheter in a cordlike vein because they are more prone to infiltration, phlebitis, and nerve damage.
Choice D rationale: The left arm is the safest site to avoid complications such as lymphedema, infection, or thrombosis.
Correct Answer is B
Explanation
A. Taking ferrous gluconate with milk is not advised because calcium in milk can interfere with the absorption of iron. The client should avoid taking iron supplements with calcium-containing products.
B. Staying upright for at least 15 minutes after taking ferrous gluconate can help prevent esophageal irritation or discomfort. This instruction is crucial for iron supplements, as lying down immediately after ingestion can cause reflux or esophagitis.
C. Taking an antacid with ferrous gluconate can reduce its absorption. The client should be advised to avoid taking antacids, calcium supplements, or certain medications close to the time of iron intake.
D. Black stools are a common and harmless side effect of iron supplementation. The client should be informed that this is expected and not a reason to notify the provider unless there are additional concerning symptoms, such as abdominal pain or constipation.
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