A nurse is caring for a client who is receiving intravenous therapy and observes redness and inflammation along the vein. The nurse should identify this finding as which of the following complications of IV therapy?

Step 1: Determine the Lidocaine Concentration

• The solution contains 2 grams (2000 mg) of lidocaine in 500 mL.
• To find the amount of lidocaine per mL:
  2000 mg ÷ 500 mL = 4 mg/mL

Step 2: Calculate the Total Dose per Hour

• The prescribed infusion rate is 4 mg per minute.
• In 1 hour (60 minutes), the total dose is:
  4 mg/min × 60 min = 240 mg/hr

Step 3: Determine the Infusion Rate in mL/hr

• Since each mL contains 4 mg of lidocaine:
  240 mg ÷ 4 mg/mL = 60 mL/hr

The nurse should set the IV pump to 60 mL/hr for the continuous IV infusion of lidocaine at a rate of 4 mg/min.

Choice A Reason:
INR (International Normalized Ratio) is incorrect. INR is a measurement used to monitor the effects of anticoagulants like warfarin. It assesses the blood's ability to clot. Filgrastim does not directly affect INR levels, so monitoring INR would not provide information about the effectiveness of filgrastim in stimulating white blood cell production.
Choice B Reason:
BUN (Blood Urea Nitrogen) is incorrect. BUN levels primarily indicate kidney function and hydration status. They are not directly influenced by filgrastim treatment. Monitoring BUN is essential for assessing kidney function but does not reflect the effectiveness of filgrastim therapy in increasing white blood cell counts.
Choice C Reason:
WBC count is correct. Filgrastim is a medication that stimulates the production of white blood cells (WBCs), particularly neutrophils. Therefore, the key laboratory value to monitor for assessing the effectiveness of filgrastim therapy is the WBC count. An increase in the WBC count, particularly in the neutrophil count, signifies the intended therapeutic effect of filgrastim in boosting the immune system's response by increasing the production of these infection-fighting cells.
Choice D Reason:
Potassium level is incorrect. Potassium levels are crucial for heart and muscle function. While certain medications might affect potassium levels, filgrastim's primary action is on stimulating white blood cell production and does not directly impact potassium levels. Monitoring potassium levels is essential for overall health but does not specifically indicate the effectiveness of filgrastim treatment.