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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Taking theophylline with coffee may increase its absorption and risk of adverse effects due to caffeine's effects on metabolism, so this statement is not appropriate.
B. Theophylline is a bronchodilator that may cause dehydration as a side effect, so limiting fluid intake is not recommended.
C. Theophylline sustained-release capsules should not be opened, crushed, or chewed, as it can alter the drug's release characteristics and increase the risk of adverse effects.
D. Monitoring blood levels of theophylline is essential to ensure therapeutic effectiveness and avoid toxicity, so the client's understanding of the need for blood level monitoring indicates comprehension of the teaching.
Correct Answer is ["19"]
Explanation
Drip rate (gtt/min) = (Volume to be infused in mL × Drop factor) ÷ Time of infusion in minutes
Given:
Volume to be infused = 350 mL Drop factor = 10 gtt/mL
Time of infusion = 3 hours = 180 minutes
Plugging these values into the formula:
Drip rate = (350 mL × 10 gtt/mL) ÷ 180 min Drip rate ≈ (3500 gtt) ÷ 180 min
Drip rate ≈ 19.4 gtt/min
Rounding to the nearest whole number, the drip rate is approximately 19 gtt/min. Therefore, the nurse should set the manual IV infusion to deliver 19 gtt/min.
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