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 A
Explanation
The nurse should administer the medication over 2 hr because amphotericin B lipid complex should be infused slowly intravenously.
Choice B is wrong because priming the tubing with 0.9% sodium chloride is not mentioned as a necessary action when administering amphotericin B lipid complex via intermittent IV bolus.
Choice C is wrong because discarding the medication if it is yellow is not mentioned as a necessary action when administering amphotericin B lipid complex via intermittent IV bolus.
Choice D is wrong because a gravity flow set is not mentioned as a necessary action when administering amphotericin B lipid complex via intermittent IV bolus.
Correct Answer is D
Explanation
The nurse should monitor the client for hypokalemia as an adverse effect of hydrochlorothiazide.
Hypokalemia refers to a low level of potassium in the blood.
Choice A is wrong because hypermagnesemia is not a commonly reported adverse effect of hydrochlorothiazide.
Choice B is wrong because hypernatremia is not a commonly reported adverse effect of hydrochlorothiazide.
Choice C is wrong because hypocalcemia is not a commonly reported adverse effect of hydrochlorothiazide.
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