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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Lie down for 1 hour after administering the medication.": This statement is not necessary for nasal cyanocobalamin administration. There is no need for the client to lie down for an extended period after administering the medication.
B. "Administer the medication into one nostril once per week.": This is the correct information. Nasal cyanocobalamin is typically administered once a week for the treatment of pernicious anemia. It's important for the nurse to emphasize the correct frequency and route of administration to ensure the effectiveness of the treatment.
C. "Plan to self-administer this medication for the next 6 months.": The duration of treatment may vary based on the healthcare provider's prescription. The nurse should instruct the client based on the specific instructions provided by the healthcare provider rather than a predetermined time frame.
D. "Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.": This statement is not a standard recommendation for nasal cyanocobalamin administration. If the client has concerns about a stuffy nose, they should consult with their healthcare provider rather than using a nasal decongestant without guidance.
Correct Answer is D
Explanation
A. Obtain a prescription for an alternative antibiotic:
Clindamycin is generally safe for penicillin-allergic clients there is no need for an alternative antibiotic.
B. Administer the clindamycin using a desensitization schedule:
Using a desensitization schedule is a specialized procedure typically reserved for certain situations and performed in a controlled environment. It is not a standard approach for administering antibiotics, and in this case, obtaining an alternative antibiotic is a more appropriate and straightforward solution.
C. Premedicate the client with epinephrine before administering the antibiotic:
Premedicating with epinephrine is not a routine practice for preventing allergic reactions to antibiotics. While epinephrine may be used in severe allergic reactions, it's not a preemptive measure in this context. It's important to address the underlying issue by avoiding the allergen (penicillin class) and using an alternative antibiotic.
D. Give the client the prescribed dose of the clindamycin:
Clindamycin is generally safe for penicillin-allergic clients since it belongs to the lincosamide class and does not share the beta-lactam ring structure responsible for allergic reactions to penicillins.
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