A nurse is reviewing a client's laboratory results before administering furosemide 40 mg IV bolus. For which of the following values should the nurse withhold the medication and contact the provider?

Choice A Reason:
The medication vial sat at room temperature for 2 hr before it was administered is correct. Medications like filgrastim typically have specific storage requirements, including temperature control. Allowing the medication vial to sit at room temperature for an extended period may compromise its stability or effectiveness, leading to potential concerns regarding medication safety. Reporting incidents related to improper medication storage is essential to ensure patient safety and prevent similar occurrences in the future.
Choice B Reason:
The client's absolute neutrophil count was 2,500/mm3 before the medication was administered. Is incorrect. A normal or adequate absolute neutrophil count (ANC) of 2,500/mm3 before administering filgrastim is not an adverse event that requires an incident report.
Choice C Reason:
The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered. Is incorrect. Flushing the IV line with dextrose 5% in water is a standard practice and not considered an adverse event or reason for filing an incident report.
Choice D Reason:
The client had chemotherapy 12 hr before the medication was administered. Is incorrect. The timing of previous chemotherapy administration, in this case, doesn't inherently suggest an adverse event requiring an incident report.

Choice A Reason:
Rotate the application site every week is correct. Rotating the application site is essential to prevent skin irritation or sensitization. Advising the client to apply the patch to a different area of clean, dry, non-hairy skin each time helps reduce the risk of skin irritation at the application site.
Choice B Reason:
The transdermal patch can cause insomnia is incorrect. Insomnia is a potential side effect of nicotine replacement therapy (NRT) patches, including transdermal nicotine patches, but it's not a universal side effect for everyone using the patch.
Choice C Reason:
Leave the patch in place for 8 hr. each day is incorrect. Transdermal nicotine patches are typically worn for 16–24 hours each day, depending on the specific product instructions. Leaving the patch on for a shorter duration might reduce its effectiveness in supporting smoking cessation.
Choice D Reason:
The transdermal patch releases nicotine rapidly into the bloodstream is incorrect. Transdermal nicotine patches deliver nicotine slowly through the skin into the bloodstream over an extended period rather than providing a rapid release. This gradual release helps reduce cravings and withdrawal symptoms associated with smoking cessation.