A nurse is monitoring for an infusion reaction for a client who is receiving a dose of IV amphotericin B. Which of the following findings should indicate to the nurse that the client is experiencing an acute infusion reaction?

Pedal edema.

Fever.

Dry cough.

Hyperglycemia.

Answer and Explanation

The Correct Answer is B

This is because fever is a common sign of an acute infusion reaction that can occur when receiving IV amphotericin B. An acute infusion reaction is caused by the release of pro-inflammatory cytokines from the fungal cell wall disruption by amphotericin B. It usually occurs within the first hour of infusion and can be prevented by administering pre-medications such as antipyretics, antihistamines, or corticosteroids.

Choice A. Pedal edema is wrong because it is not a typical sign of an acute infusion reaction.

Pedal edema may indicate fluid overload, heart failure, or renal impairment, which are not directly related to amphotericin B infusion.

Choice C. Dry cough is wrong because it is not a typical sign of an acute infusion reaction.

Dry cough may indicate an allergic reaction, pulmonary infection, or interstitial lung disease, which are not directly related to amphotericin B infusion. Choice D. Hyperglycemia is wrong because it is not a typical sign of an acute infusion reaction.

Hyperglycemia may indicate diabetes mellitus, steroid use, or stress response, which are not directly related to amphotericin B infusion.

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Correct Answer is B

Explanation

This is because TPN solutions are concentrated and can cause thrombosis of peripheral veins, so a central venous catheter is usually required. TPN should only be used when the intestine is unavailable or unable to absorb nutrients.

Choice A is wrong because a midline catheter is a type of peripheral catheter that can only be used for solutions with low or moderate osmolarity, not for TPN.

Choice C is wrong because subcutaneous administration is not a route for delivering TPN, which requires intravenous infusion.

Choice D is wrong because intraosseous administration is an emergency route for delivering fluids and drugs when intravenous access is not available, not for TPN.

A. The client had chemotherapy 12 hr before the medication was administered. B. The medication vial sat at room temperature for 2 hr before it was administered. C. The client’s absolute neutrophil count was 2,500/mm3 before the medication was administered. D. The nurse flushed the client’s IV line with dextrose 5% in water before and after the medication was administered.

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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A nurse is monitoring for an infusion reaction for a client who is receiving a dose of IV amphotericin B. Which of the following findings should indicate to the nurse that the client is experiencing an acute infusion reaction?

Nursing Test Bank

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