A nurse recently administered filgrastim intravenously to a client who has cancer and is receiving cytotoxic chemotherapy. For which of the following data, discovered after the medication was administered, should the nurse file an incident report?
The client's absolute neutrophil count was 2,500/mm3 before the medication was administered.
The medication vial sat at room temperature for 2 hr before it was administered.
The client had chemotherapy 12 hr before the medication was administered.
The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered.
The Correct Answer is B
Choice A rationale: The client's initial neutrophil count might be within an acceptable range for filgrastim administration.
Choice B rationale: Filgrastim, a medication used to increase white blood cell count, should ideally be stored and administered as per manufacturer recommendations.
Allowing it to sit at room temperature for an extended period could affect its potency or efficacy, necessitating an incident report.
Choice C rationale: Having chemotherapy before filgrastim administration might not necessitate an incident report.
Choice D rationale: Flushing the IV line with dextrose solution is a routine practice and might not relate to the need for an incident report.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Choice A rationale: For subcutaneous injections like enoxaparin, the entire length of the needle needs to be inserted to ensure that the medication reaches the fatty tissue under the skin and reduces the risk of bleeding or bruising.
Choice B rationale: The client should not massage the insertion site after injecting the medication, as this may increase the risk of hematoma formation.
Choice C rationale: The client should alternate injection sites between the sides of the abdomen to prevent bruising and irritation.
Choice D rationale: The client should also grasp the skin between the thumb and forefinger while injecting the medication to create a fold of tissue. This ensures that the medication is delivered into the subcutaneous layer and not the muscle.
Choice E rationale: The client should not expel the air bubble from the prefilled syringe, as this helps to seal the medication in the tissue and prevent leakage while ensuring that you receive the full dose of medication.
Correct Answer is A
Explanation
Choice A rationale: Dopamine is administered in septic shock to increase blood pressure. If the client continues to exhibit hypotension, increasing the rate of infusion may be necessary to achieve the desired therapeutic effect.
Choice B rationale: Chest pain might indicate other issues but might not directly relate to the need for increasing the dopamine infusion rate.
Choice C: Extravasation is a complication of IV therapy but doesn’t necessarily warrant an increase in the dopamine infusion rate.
Choice D rationale: Headache might occur due to various reasons but might not solely indicate the need to increase the dopamine infusion rate.
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