A nurse is caring for a client who has a prescription for epoetin alfa. Which of the following routes should the nurse plan to use for administration?

A. The client had a decreased neutrophil count before the medication was administered: This finding may be expected in a client undergoing cytotoxic chemotherapy and receiving filgrastim to stimulate neutrophil production. It is not an indication for an incident report.
B. The client had chemotherapy 12 hr before the medication was administered: The timing of chemotherapy administration is not typically a reason to complete an incident report unless it conflicts with specific medication guidelines or protocols.
C. The vial was out of the refrigerator for 2 hr before the medication was administered:

Filgrastim should be stored in the refrigerator and protected from light. Allowing the medication vial to be out of the refrigerator for an extended period may compromise its stability and effectiveness, potentially leading to adverse effects or reduced efficacy. Therefore, this finding warrants completion of an incident report.
D. The client reported feeling nauseous after the medication was administered: Nausea is a known side effect of filgrastim and is not typically an indication for completing an incident report unless it is severe or persistent and requires intervention.

A. Leg tenderness: Leg tenderness can be a sign of deep vein thrombosis (DVT), a rare but serious complication associated with oral contraceptives. Therefore, the nurse should report this finding immediately for further evaluation and management to prevent complications such as pulmonary embolism.

B. Cramps: Mild cramps are a common side effect of oral contraceptives and do not typically require immediate reporting unless they are severe or persistent.
C. Nausea: Nausea is a common side effect of oral contraceptives, especially during the initial weeks of use. It usually improves over time and does not typically require immediate reporting unless it is severe or persistent.
D. Abdominal bloating: Abdominal bloating is a common side effect of oral contraceptives and is usually mild and self-limiting. It does not typically require immediate reporting unless it is severe or persistent.