A nurse is caring for a client who is taking sertraline and reports a desire to begin taking supplements.
Which of the following supplements should the nurse advise the client to avoid?
St. John’s Wort.
Black cohosh.
Coenzyme Q.
Ginger root.
The Correct Answer is A
The nurse should advise the client to avoid taking St. John’s Wort with sertraline because it can increase the risk of a rare but serious condition called serotonin syndrome. Serotonin syndrome can cause symptoms such as confusion, hallucination, seizure, extreme changes in blood pressure, increased heart rate, fever, excessive sweating, shivering or shaking, blurred vision, muscle spasm or stiffness, tremor, incoordination, stomach cramp, nausea, vomiting, and diarrhoea.
Choice B. Black cohosh is wrong because it is a herbal supplement that is used to treat menopausal symptoms and has no known interaction with sertraline.
Choice C. Coenzyme Q is wrong because it is a natural substance that is involved in energy production and has no known interaction with sertraline.
Choice D. Ginger root is wrong because it is a spice that is used to treat nausea and has no known interaction with sertraline.
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Correct Answer is D
Explanation
The nurse who caused the error is responsible for completing an incident report. An incident report is a tool for documenting any event that deviates from the standard of care or causes harm to a client, staff member, or visitor. The purpose of an incident report is to improve quality and safety, not to assign blame or punish anyone. The nurse who caused the error should fill out the report as soon as possible after the event, providing factual and objective information.
A. The quality improvement committee is not directly involved in the incident and does not complete the report. The committee may review the report later to identify trends and areas for improvement.
B. The charge nurse is not responsible for completing the report, although they may assist or supervise the nurse who caused the error.The charge nurse may also notify the provider and other relevant staff members about the incident.
C.The nurse who caused the error may be involved in providing details and information about the incident, but the nurse who discovers the error is the one responsible for completing the incident report to ensure that all relevant information is accurately documented.
D. It is crucial for the nurse who discovers the error to complete the incident report to ensure that all relevant details are accurately documented. This allows for a thorough investigation and implementation of corrective actions to prevent future errors.
Correct Answer is D
Explanation
The correct answer is d
Choice A reason:
Administering filgrastim 12 hours after chemotherapy does not typically require an incident report. Filgrastim is often given at least 24 hours after chemotherapy to avoid the risk of increasing the toxicity of the chemotherapy agents. While the timing is closer than recommended, it does not necessarily constitute an error unless specific instructions for the timing were provided by the prescribing physician.
Choice B reason:
The medication vial sitting at room temperature for 2 hours before administration does not require an incident report. Filgrastim can be left out at room temperature for up to 24 hours before use. This is within the safe handling guidelines for the medication.
Choice C reason:
An absolute neutrophil count (ANC) of 2,500/mm³ is within the normal range, which is typically 1,500-8,000/mm³. Filgrastim is used to increase neutrophil counts in patients with low ANC due to chemotherapy. Since the ANC was not low before administration, this would not necessitate an incident report, although it may prompt a review of the necessity of the medication.
Choice D reason:
Flushing the client's IV line with dextrose 5% in water before and after the medication was administered is not the standard procedure and could potentially lead to medication errors or adverse effects. Filgrastim should be diluted in glucose 5% in water for intravenous infusion, but not used to flush the line. This deviation from the standard protocol is what necessitates an incident report.
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