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A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?

PaCO2 30 mm Hg

Oxygen saturation 96

Decrease in protein

Increase in BP

Answer and Explanation

The Correct Answer is D

Choice A rationale:

PaCO2 levels are not typically affected by albumin infusions.

Choice B rationale:

Oxygen saturation of 96 is a normal finding and is not directly related to an albumin infusion.

Choice C rationale:

Albumin infusion would not typically cause a decrease in protein levels. A decrease in protein is not expected after albumin infusion, as albumin is a protein itself.

Choice D rationale:

Albumin is a plasma expander that increases the blood volume and the blood pressure in a client who is in shock.

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Correct Answer is C

Explanation

Choice A rationale:

A BUN level of 15 mg/dL is within a normal range.

Choice B rationale:

A potassium level of 3.8 mEq/L is within a normal range.

Choice C rationale:

Dizziness upon standing could indicate orthostatic hypotension, which could be a concern following administration of a diuretic like furosemide.

Choice D rationale:

Difficulty hearing is not typically associated with furosemide administration.

A. The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered. B. The client's absolute neutrophil count was 2.500/mm3 before the medication was administered. C. The client had chemotherapy 12 hr before the medication was administered. D. The medication vial sat at room temperature for 2 hr before it was administered.

Correct Answer is C

Explanation

A: Flushing an IV line with dextrose 5% in water before and after medication administration is a common practice to ensure that the medication is delivered properly and to prevent interactions in the IV line. This would not typically require an incident report.
B: An absolute neutrophil count of 2.500/mm3 is within the normal range for patients undergoing chemotherapy and would not typically necessitate an incident report.
C: Having chemotherapy 12 hours before the administration of filgrastim does not contraindicate its use and is within the appropriate time frame as filgrastim is often given after chemotherapy to help recover white blood cell counts.
D: According to the guidelines, filgrastim should be stored in the refrigerator and allowing it to sit at room temperature for 2 hours could compromise its effectiveness. This is a deviation from the medication's storage requirements and could potentially harm the patient, thus an incident report should be filed.

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A nurse is caring for a client who is in shock and is receiving an infusion of albumin. Which of the following findings should the nurse expect?

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