The nurse is caring for a patient receiving chemotherapy who is admitted with an absolute neutrophil count (ANC) of 459 cells/ulu. The healthcare provider orders G-CSF (filgrastim). Which action will the nurse take to promote safe and effective use of filgrastim for this patient?

Monitor the patient's ANC daily and stop medication when the ANC is greater than 20,000 cells/ulu.

Teach the patient how to administer the medication via intramuscular.

Ensure the patient understands the risk of bone pain and how to manage it.

Administer filgrastim as needed for symptoms of infection.

Answer and Explanation

The Correct Answer is C

Choice A reason: Monitoring the patient's absolute neutrophil count (ANC) daily and stopping medication when the ANC is greater than 20,000 cells/uL is an essential aspect of using filgrastim safely. However, this is typically managed by the healthcare provider and not the primary action for the nurse to take for patient education. The nurse's role focuses more on educating the patient about potential side effects and self-care.

Choice B reason: Teaching the patient how to administer the medication via intramuscular is not relevant for filgrastim, as it is typically administered via subcutaneous injection. Proper administration technique is crucial for ensuring the medication's effectiveness, but this choice does not accurately reflect the standard administration method for filgrastim.

Choice C reason: Ensuring the patient understands the risk of bone pain and how to manage it is crucial for promoting safe and effective use of filgrastim. Bone pain is a common side effect of filgrastim due to the stimulation of bone marrow to produce more neutrophils. Educating the patient about this potential side effect and providing strategies for managing the pain, such as using over-the-counter pain relievers, helps improve patient comfort and adherence to the medication.

Choice D reason: Administering filgrastim as needed for symptoms of infection is not appropriate. Filgrastim is used to stimulate neutrophil production and prevent infection, rather than treating active infections. The medication should be administered according to the prescribed schedule, not based on the presence of infection symptoms.

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Correct Answer is ["A","B","D"]

Explanation

Choice A reason: Candidiasis, or oral thrush, is a common side effect of inhaled corticosteroids like budesonide. Patients should be educated on the importance of rinsing their mouth after using the inhaler to reduce the risk of this fungal infection.

Choice B reason: Dysphonia, or hoarseness, is another potential side effect of budesonide inhalers. This occurs due to the medication's effect on the vocal cords and can be minimized by using a spacer and rinsing the mouth after inhalation.

Choice C reason: Weight loss is not a common side effect of inhaled budesonide. Inhaled corticosteroids typically do not affect body weight in the same way that systemic corticosteroids might.

Choice D reason: Headache is a potential side effect of budesonide inhalers. Patients should be informed about this possibility and advised to manage headaches with appropriate over-the-counter medications if needed.

A. Remind the patient that they will be responsible for caring for the ileostomy after discharge. B. Reassure the patient that this procedure will be reversed in a few months. C. Acknowledge the patient's reluctance and initiate discussion to explore their feelings. D. Discuss with the medical team during interdisciplinary rounds the need for a psychiatric referral.

Correct Answer is C

Explanation

Choice A reason: Reminding the patient that they will be responsible for caring for the ileostomy after discharge may increase their anxiety and reluctance. It does not address the underlying concerns or feelings.

Choice B reason: Reassuring the patient that the procedure will be reversed in a few months is not always accurate and may provide false hope. Each patient's situation is unique, and not all ileostomies are temporary.

Choice C reason: Acknowledging the patient's reluctance and initiating a discussion to explore their feelings is the most appropriate response. This approach allows the nurse to understand the patient's concerns, provide emotional support, and offer practical solutions to help the patient feel more comfortable with ostomy care.

Choice D reason: Discussing the need for a psychiatric referral during interdisciplinary rounds is not the immediate step. The nurse should first address the patient's feelings and concerns directly and provide support.

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The nurse is caring for a patient receiving chemotherapy who is admitted with an absolute neutrophil count (ANC) of 459 cells/ulu. The healthcare provider orders G-CSF (filgrastim). Which action will the nurse take to promote safe and effective use of filgrastim for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient, newly diagnosed with chronic obstructive pulmonary disease (COPD), who has an order for a budesonide inhaler. When planning medication teaching, the nurse will plan to include which potential side effects of this medication? (Select All That Apply)

Correct Answer is ["A","B","D"]

Explanation

The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care. What is the nurse's most appropriate response to this observation?

Correct Answer is C

Explanation

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The nurse is caring for a patient with inflammatory bowel disease who has been discharged with an ileostomy. The patient expresses reluctance to participate in aspects of ostomy care. What is the nurse's most appropriate response to this observation?