A nurse recently administered filgrastim intravenously to a client who has ccer 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 nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered.
The client's absolute neutrophil count was 2.500/mm3 before the medication was administered.
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 Correct Answer is D
A: Flushing an IV line with dextrose 5% in water before and after medication administration is a common practice to ensure that the medication is delivered properly and to prevent interactions in the IV line. This would not typically require an incident report.
B: An absolute neutrophil count of 2.500/mm3 is within the normal range for patients undergoing chemotherapy and would not typically necessitate an incident report.
C: Having chemotherapy 12 hours before the administration of filgrastim does not contraindicate its use and is within the appropriate time frame as filgrastim is often given after chemotherapy to help recover white blood cell counts.
D: According to the guidelines, filgrastim should be stored in the refrigerator and allowing it to sit at room temperature for 2 hours could compromise its effectiveness. This is a deviation from the medication's storage requirements and could potentially harm the patient, thus an incident report should be filed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Hyperglycemia is not typically associated with an acute infusion reaction to amphotericin B.
Choice B rationale:
A dry cough is a common side effect of amphotericin B, but it is not an indicator of an acute infusion reaction.
Choice C rationale:
Pedal edema is not a typical sign of an acute infusion reaction to amphotericin B.
Choice D rationale:
Fever, along with other symptoms like chills, fever, nausea, and vomiting, can be indicative of an acute infusion reaction to amphotericin B. It may require stopping the infusion and providing appropriate treatment.
Correct Answer is D
Explanation
Choice A rationale:
A sodium level of 137 mEq is within a normal range.
Choice B rationale:
A hemoglobin level of 15 g/dL is within a normal range.
Choice C rationale:
A hematocrit level of 43% is within a normal range.
Choice D rationale:
Creatinine 2.5 mg/dL is elevated, indicating possible kidney impairment. Tobramycin is known to be nephrotoxic, and administering it to a patient with impaired kidney function could exacerbate the condition. Therefore, this value should be reported to the provider before administering the medication.
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