A nurse is reviewing the medical record of a client who just received a dose of IV filgrastim. The client has cancer and is receiving cytotoxic chemotherapy. For which of the following findings should the nurse complete an incident report?
The client had a decreased neutrophil count before the medication was administered.
The client had chemotherapy 12 hr before the medication was administered.
The vial was out of the refrigerator for 2 hr before the medication was administered.
The client reported feeling nauseous after the medication was administered.
The Correct Answer is C
A. The client had a decreased neutrophil count before the medication was administered: This finding may be expected in a client undergoing cytotoxic chemotherapy and receiving filgrastim to stimulate neutrophil production. It is not an indication for an incident report.
B. The client had chemotherapy 12 hr before the medication was administered: The timing of chemotherapy administration is not typically a reason to complete an incident report unless it conflicts with specific medication guidelines or protocols.
C. The vial was out of the refrigerator for 2 hr before the medication was administered:
Filgrastim should be stored in the refrigerator and protected from light. Allowing the medication vial to be out of the refrigerator for an extended period may compromise its stability and effectiveness, potentially leading to adverse effects or reduced efficacy. Therefore, this finding warrants completion of an incident report.
D. The client reported feeling nauseous after the medication was administered: Nausea is a known side effect of filgrastim and is not typically an indication for completing an incident report unless it is severe or persistent and requires intervention.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Amphotericin B lipid complex naturally appears as an opaque, yellow to amber colored suspension. Discarding the medication because it is yellow is incorrect, as this is its expected normal appearance.
B. Amphotericin B lipid complex is highly incompatible with saline solutions and will precipitate if it comes into contact with them. The IV tubing must be primed and flushed strictly with 5% Dextrose in Water (D5W), not 0.9% sodium chloride.
C. The standard recommended administration protocol for amphotericin B lipid complex is to deliver the intravenous infusion at a rate of 2.5 mg/kg/hour, which typically translates to an overall infusion duration of approximately 2 hours.
D. To avoid accidental rapid infusion, which can induce severe adverse effects such as acute hypotension, cardiac arrhythmias, and cardiopulmonary arrest, amphotericin B must always be regulated by an electronic infusion pump rather than a manual gravity flow set.
Correct Answer is ["1.5"]
Explanation
Convert the client's weight from pounds to kilograms by dividing by 2.2. 198 lb / 2.2 = 90 kg
Calculate the dose of filgrastim in micrograms by multiplying the client's weight in kilograms by the prescribed dose per kilogram. 90 kg x 5 mcg/kg = 450 mcg
Calculate the volume of filgrastim in milliliters by dividing the dose in micrograms by the concentration of the available solution. 450 mcg / 300 mcg/mL = 1.5 mL
Round the answer to the nearest tenth. The nurse should plan to give 1.5 mL of filgrastim with each dose.
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