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

Explanation

Choice A reason:

Ondansetron on a PRN basis is used to manage nausea and vomiting. In patients with inflammatory bowel disease, especially during an inpatient stay, controlling nausea is important to maintain comfort and prevent dehydration. This makes it an appropriate symptomatic treatment.

Choice B reason:

Vitamin B12 injections may be indicated in patients with Crohn’s disease who have malabsorption issues, particularly if the terminal ileum is involved. However, they are not routinely given to all patients with inflammatory bowel disease solely for the prevention of pernicious anemia.

Choice C reason:

Antidiarrheal medications are generally contraindicated in inflammatory bowel disease, as they can mask important symptoms and may increase the risk of complications like toxic megacolon, especially if administered before meals.

Choice D reason:

Beta adrenergic blockers are not used to reduce bowel motility. Their primary use is in cardiovascular conditions, and they do not address the gastrointestinal symptoms associated with inflammatory bowel disease.

A. "I will take this medication as needed during flares of joint pain." B. "I will avoid drinking alcohol while taking this medication." C. "I will call my provider if I develop a sore throat or fever." D. "I will use contraception while taking this medication."

Correct Answer is A

Explanation

Choice A reason: Methotrexate is a disease-modifying antirheumatic drug (DMARD) that must be taken regularly as prescribed, not just during flares of joint pain. It helps to prevent disease progression and joint damage. This statement indicates a misunderstanding of the medication regimen and requires further teaching.

Choice B reason: Avoiding drinking alcohol while taking methotrexate is important because alcohol can increase the risk of liver damage, a potential side effect of methotrexate. This statement indicates proper understanding.

Choice C reason: Calling the provider if a sore throat or fever develops is important because methotrexate can suppress the immune system, increasing the risk of infections. This statement indicates proper understanding.

Choice D reason: Using contraception while taking methotrexate is crucial because methotrexate can cause birth defects. This statement indicates proper understanding.

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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

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Correct Answer is A

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Correct Answer is A

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