A nurse is preparing an educational training session about collaborating with the provider to prevent medication errors. Which of the following information should the nurse include in the teaching?

A) WBC count: Filgrastim is a granulocyte colony-stimulating factor (G-CSF) medication used to stimulate the production of white blood cells (WBCs), particularly neutrophils, in individuals with neutropenia. Therefore, monitoring the WBC count is essential to evaluate the effectiveness of filgrastim therapy. An increase in WBC count indicates a response to treatment, helping to prevent or manage neutropenic complications such as infections.

B) INR: The international normalized ratio (INR) is a laboratory test used to monitor the effectiveness of anticoagulant therapy, particularly warfarin (Coumadin). It measures the clotting ability of the blood and is not directly related to filgrastim therapy. Therefore, monitoring the INR is not appropriate for evaluating the effectiveness of filgrastim treatment.

C) BUN: Blood urea nitrogen (BUN) is a laboratory test used to assess kidney function and hydration status. It measures the concentration of urea nitrogen in the blood and is not directly related to filgrastim therapy. Monitoring BUN levels may be indicated for assessing renal function in certain clinical contexts but is not specific to evaluating the effectiveness of filgrastim treatment.

D) Potassium level: Monitoring potassium levels is important for assessing electrolyte balance and kidney function but is not directly related to filgrastim therapy. Potassium levels may be affected by various factors, including medications, diet, and renal function. However, they do not directly reflect the effectiveness of filgrastim in stimulating WBC production.

Answer: B. Dispose of the remaining medication while another nurse observes.

Rationale:

A) Return the remaining medication to the facility's pharmacy: Return the remaining medication to the facility's pharmacy: This is not typical practice for partial doses of controlled substances like hydromorphone. The pharmacy usually does not accept leftover portions of such medications.

B) Dispose of the remaining medication while another nurse observes: This is the correct and appropriate action. When administering controlled substances, any unused portion must be properly disposed of to prevent misuse or diversion. Having another nurse observe and document the disposal ensures accountability and adherence to safety protocols.

C) Store the remaining half of the pill in the automated medication dispensing system: Storing a partial tablet of a controlled substance is not appropriate. The automated medication dispensing system is designed to store and dispense whole doses of medication as prescribed. Storing partial tablets can lead to confusion, contamination, and potential misuse. It also increases the risk of medication errors, as the partial dose may not be easily identifiable or accurately accounted for.

D) Place the remaining half of the pill in the unit-dose package: his practice is not acceptable for controlled substances due to the risk of misuse, contamination, and the potential for medication errors. Controlled substances require strict handling and disposal procedures to ensure safety and compliance with regulatory standards. Placing a partial tablet back into the unit-dose package does not align with these standards and could lead to inappropriate use or administration.