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 nurse flushed the client's IV line with dextrose 5% in water before and after 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 D
A. The client's absolute neutrophil count was 2.500/mm³ before the medication was administered:
Incorrect Explanation: This is a normal data point that does not suggest an adverse event or error.
Explanation: An absolute neutrophil count of 2.500/mm³ is within the normal range, and there is no indication of a problem related to the administration of filgrastim based on this information.
B. The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered:
Incorrect Explanation: Routine flushing of the IV line with appropriate solutions is a standard practice and not indicative of an incident.
Explanation: Flushing the IV line with dextrose 5% in water before and after medication administration is a routine procedure to maintain line patency and prevent interactions between medications.
C. The client had chemotherapy 12 hours before the medication was administered:
Incorrect Explanation: The timing of chemotherapy does not necessarily indicate an incident.
Explanation: Knowing the timing of chemotherapy is important for overall patient care, but it doesn't necessarily indicate an incident or error related to the administration of filgrastim.
D. The medication vial sat at room temperature for 2 hours before it was administered:
Correct Answer: This is the data point that should lead to filing an incident report.
Explanation: Many medications, including filgrastim, have specific storage requirements to ensure their effectiveness and safety. Allowing a medication vial to sit at room temperature for an extended period can compromise its stability and effectiveness. This situation should be reported as it involves a potential deviation from proper medication storage and handling procedures.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. The nurse should report the Total bilirubin 1.5 mg/dL to the provider.
Amitriptyline is an antidepressant medication, and elevated total bilirubin levels can indicate potential liver dysfunction or impairment. It's important to report any significant changes in liver function values to the provider, especially when a client is taking medications that can affect liver metabolism. The other laboratory values mentioned are within normal ranges and would not typically be of concern in the context of amitriptyline use.
B. Potassium 4.2 mEq/L:
This value is within the normal range. Potassium levels of 4.2 mEq/L are considered normal. While potassium levels are important to monitor, this result does not indicate a need for immediate reporting.
C. WBC count 5,000/mm³:
This value is within the normal range. A white blood cell (WBC) count of 5,000/mm³ is within the typical range. It suggests a normal immune response and does not require reporting.
D. Hct 44: This value is incorrect. The hematocrit (Hct) value of 44 is not accompanied by the unit of measurement (percentage or fraction). Hematocrit values measure the proportion of red blood cells in the blood and are usually reported as a percentage. If this value is indeed 44%, it falls within a normal range for both men and women. However, if the unit is different (such as a 44% fraction), it might be an incorrect unit conversion. The nurse should verify the unit of measurement and report any discrepancies or errors to the provider for clarification.
Correct Answer is A
Explanation
A. The client has a history of a severe penicillin allergy:
Correct Answer: This is the priority information for the nurse to report to the provider.
Explanation: Cefuroxime is a cephalosporin antibiotic. Individuals with a history of severe penicillin allergy may also have an increased risk of cross-reactivity with cephalosporin antibiotics. This potential cross-reactivity needs to be evaluated by the provider to determine the safety of prescribing cefuroxime for the client.
B. The client takes an aspirin daily:
Incorrect Explanation: While the daily use of aspirin should be considered when prescribing medications, it is not the priority in this scenario.
Explanation: Aspirin use might affect bleeding risk, but it is not directly related to the potential interaction with cefuroxime. The client's severe penicillin allergy takes precedence in terms of immediate concern.
C. The client reports a history of nausea with cefuroxime:
Incorrect Explanation: A history of nausea with cefuroxime is relevant but is not as critical as the severe penicillin allergy.
Explanation: While the nurse should consider the client's history of nausea with cefuroxime, it is not as urgent as addressing the potential cross-reactivity with penicillin.
D. The client has a BUN level of 18 mg/dL:
Incorrect Explanation: The BUN level is not the priority in this context.
Explanation: A BUN level of 18 mg/dL is within the normal range and is not immediately relevant to the decision about prescribing cefuroxime.
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