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/mm before the medication was administered

The nurse flushed the client's (V line with dextrose 5% in water before and after 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

Answer and Explanation

The Correct Answer is C

A. The client's absolute neutrophil count was 2.500/mm before the medication was administered:
This information does not indicate an error in the administration process. The absolute neutrophil count being 2.500/mm before the medication was given is relevant to the client's condition but does not suggest an incident related to the administration of filgrastim.
B. The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered:
Flushing the IV line with dextrose 5% in water is a standard practice before and after medication administration. This action helps ensure that the medication is effectively delivered and that the line remains patent. There is no indication of an error in this case.
C. The medication vial sat at room temperature for 2 hr before it was administered:
Filgrastim is a medication that typically requires refrigeration to maintain stability. Allowing it to sit at room temperature for an extended period can affect its efficacy and safety. This is a deviation from the recommended storage conditions and should be reported as an incident to assess potential consequences.
D. The client had chemotherapy 12 hr before the medication was administered:
This information does not necessarily suggest an incident related to the administration of filgrastim. The timing of chemotherapy is an essential consideration in cancer treatment protocols. Filgrastim is often administered to support recovery from the hematopoietic effects of chemotherapy.

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Correct Answer is C

Explanation

A. Discard the medication if it is yellow: Amphotericin B lipid complex is typically yellow in color. This is a normal characteristic of the medication, and it should not be discarded based on color. The nurse should be aware of the expected color and administer the medication as prescribed.
B. Administer the medication over 2 hr: Amphotericin B lipid complex is often administered over an extended period (usually over 2 to 6 hours) to minimize the risk of infusion-related reactions. However, if the prescription specifies an intermittent IV bolus, the nurse should follow the prescribed administration route and rate.
C. Prime the tubing with 0.9% sodium chloride (Correct Answer): Amphotericin B lipid complex can interact with dextrose-containing solutions, leading to the formation of a precipitate. Therefore, it is recommended to prime the IV tubing with 0.9% sodium chloride before administering the medication to prevent any potential interaction.
D. Use a gravity flow set: The choice of infusion set may depend on the specific institutional policies and the patient's condition. However, using a pump or a controlled infusion device is often recommended when administering medications like amphotericin B to ensure accurate infusion rates and reduce the risk of adverse reactions.

A. Transparent membrane dressing B. Hydrocolloid dressing C. Sterile gauze bandage D. Adhesive bandage

Correct Answer is A

Explanation

A. Transparent membrane dressing:
This is the correct answer. Transparent dressings are commonly used to cover peripheral IV catheter insertion sites. They provide a clear view of the site, allow for easy monitoring, and create a barrier against contamination while maintaining a moist environment.

B. Hydrocolloid dressing:
Hydrocolloid dressings are generally used for wounds with minimal exudate. They are not typically used for securing peripheral IV catheters.

C. Sterile gauze bandage:
Sterile gauze bandages may be used for specific types of wounds but are not the preferred choice for covering peripheral IV catheter sites. Gauze dressings may increase the risk of contamination and do not provide a clear view of the site.

D. Adhesive bandage:
Adhesive bandages (commonly known as band-aids) are not suitable for covering peripheral IV catheter sites. They are typically used for small wounds or cuts.

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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?

Nursing Test Bank

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