A nurse recently administered filgrastim intravenously to a client who has ccer 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 nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered.
The client's absolute neutrophil count was 2.500/mm3 before the medication was administered.
The client had chemotherapy 12 hr before the medication was administered.
The medication vial sat at room temperature for 2 hr before it was administered.
The Correct Answer is C
A: Flushing an IV line with dextrose 5% in water before and after medication administration is a common practice to ensure that the medication is delivered properly and to prevent interactions in the IV line. This would not typically require an incident report.
B: An absolute neutrophil count of 2.500/mm3 is within the normal range for patients undergoing chemotherapy and would not typically necessitate an incident report.
C: Having chemotherapy 12 hours before the administration of filgrastim does not contraindicate its use and is within the appropriate time frame as filgrastim is often given after chemotherapy to help recover white blood cell counts.
D: According to the guidelines, filgrastim should be stored in the refrigerator and allowing it to sit at room temperature for 2 hours could compromise its effectiveness. This is a deviation from the medication's storage requirements and could potentially harm the patient, thus an incident report should be filed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
A hematocrit (Hct) value of 44% is within the expected range and does not require immediate reporting.
Choice B rationale:
A white blood cell (WBC) count of 5,000/mm3 falls within the normal range and does not require immediate reporting.
Choice C rationale:
Elevated total bilirubin levels can indicate potential liver dysfunction, which can be a concern when a client is taking medications like amitriptyline. The nurse should report this value for further evaluation.
Choice D rationale:
A potassium level of 4.2 mEq/L is within the normal range and does not require immediate reporting.
Correct Answer is D
Explanation
Choice A rationale:
Taking an HMG-CoA reductase inhibitor (statin) is not directly related to digoxin toxicity.
Choice B rationale:
Having a prolapsed mitral valve is not a known risk factor for digoxin toxicity.
Choice C rationale:
Having a history of COPD is not directly associated with digoxin toxicity.
Choice D rationale:
High-ceiling diuretics (loop diuretics) can lead to electrolyte imbalances, such as hypokalemia, which can increase the risk of digoxin toxicity. Potassium plays a role in the effects of digoxin on the heart, and low levels can potentiate toxicity.
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