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 had chemotherapy 12 hr before the medication was administered.
The medication vial sat at room temperature for 2 hr before it was administered.
The client's absolute neutrophil count was 2,500/mm³ 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 A
Choice A rationale: Administering filgrastim after chemotherapy is a standard practice to boost white blood cell count. However, filgrastim should not be given within 24 hours before or after chemotherapy, as it can affect the efficacy and increase the risk of side effects. Administering the medication 12 hours after chemotherapy falls within this contraindicated window, necessitating an incident report.
Choice B rationale: Filgrastim can be stored at room temperature for short periods, and 2 hours is generally within acceptable limits for stability.
Choice C rationale: An absolute neutrophil count of 2,500/mm³ is within the normal range, and there is no contraindication for administering filgrastim.
Choice D rationale: Flushing the client's IV line with dextrose 5% in water before and after administering filgrastim is not appropriate, as this medication is typically administered with saline solution. Using an incorrect flushing solution could affect the medication's efficacy or compatibility, necessitating an incident report.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Methimazole is a medication used to treat hyperthyroidism, a condition where the thyroid gland produces too much thyroid hormone.
Bradycardia, or a slow heart rate, can be a sign that the client’s thyroid hormone levels have become too low, indicating that the dose of methimazole may need to be decreased.
Choice A is wrong because Exophthalmos, is not an indication for a lower dose of methimazole as it is a symptom of Graves’ disease itself and not related to the medication.
Choice B is wrong because Diaphoresis, or excessive sweating, is also not an indication for a lower dose of methimazole as it can be a symptom of hyperthyroidism.
Choice D is wrong because Weight loss, is also not an indication for a lower dose of methimazole as it can be a symptom of hyperthyroidism.
Correct Answer is D
Explanation
Gentamicin can harm your kidneys.
An elevated creatinine level can be a sign of kidney damage.
The nurse should report this finding to the provider immediately.
Choice A is wrong because Fasting blood glucose 130 mg/dL, is not an answer because it is not mentioned as an adverse effect of gentamicin in the search results.
Choice B is wrong because WBC 11,000/mm3, is not an answer because it is not mentioned as an adverse effect of gentamicin in the search results.
Choice C is wrong because Potassium 4.5 mEq/L, is not an answer because it is not mentioned as an adverse effect of gentamicin in the search results.
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