The nurse is administering filgrastim (G-CSF) to a patient with colorectal cancer after finishing a cycle of chemotherapy.
Which SMART Outcome will this intervention help to achieve?
The patient will have one formed bowel movement by the end of the shift.
The patient's skin will be free of petechiae and purpura by discharge.
The patient will tolerate meals without reports of nausea by the end of the day.
The patient will be free from infection by discharge.
The Correct Answer is D
Choice A rationale
Filgrastim (G-CSF) is used to stimulate the production of white blood cells to decrease the risk of infection. A formed bowel movement is unrelated to the specific outcomes of this medication.
Choice B rationale
While filgrastim can improve overall blood cell counts, its primary goal is to enhance neutrophil counts, rather than addressing skin petechiae or purpura, which may be related to platelet levels.
Choice C rationale
Filgrastim does not target gastrointestinal symptoms such as nausea. Instead, it is aimed at restoring neutrophil levels to reduce infection risk.
Choice D rationale
Filgrastim is specifically designed to increase neutrophil counts, thus helping the patient to be free from infections by discharge, which is a SMART goal.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Pain from mucositis and oral tissue injury is a significant concern for patients undergoing chemotherapy. However, it is not typically life-threatening and can be managed with appropriate pain relief measures and oral care.
Choice B rationale
Weakness and fatigue with activity are common side effects of chemotherapy and the disease process itself. While these symptoms impact the patient's quality of life, they do not usually require urgent intervention.
Choice C rationale
Blood pressure of 90/64 mmHg, pulse of 102 beats per minute, and oral temperature of 38.5 degrees Celsius suggest possible sepsis or severe infection. These vital signs indicate an urgent need for intervention to prevent further deterioration and potentially life-threatening complications.
Choice D rationale
Scattered ecchymosis and petechiae are signs of thrombocytopenia (low platelet count), which is a common complication of leukemia and its treatment. While important to monitor and manage, these findings are not typically as urgent as signs of sepsis or severe infection.
Correct Answer is A
Explanation
Choice A rationale
Notifying the healthcare provider is the appropriate first action when significant ecchymosis is observed in a patient with Cushing's syndrome, as it may indicate a need for medical intervention.
Choice B rationale
Administering insulin is not relevant as the primary concern here is the ecchymosis, not hyperglycemia.
Choice C rationale
While providing skin care is important, it does not address the potential underlying cause of the ecchymosis, necessitating provider notification first.
Choice D rationale
Monitoring intake and output and daily weight is a general care measure but does not address the immediate concern of ecchymosis observed.
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