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/mm before the medication was administered

The nurse flushed the client's (V line with dextrose 5% in water before and after 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

Answer and Explanation

The Correct Answer is C

A. The client's absolute neutrophil count was 2.500/mm before the medication was administered:
This information does not indicate an error in the administration process. The absolute neutrophil count being 2.500/mm before the medication was given is relevant to the client's condition but does not suggest an incident related to the administration of filgrastim.
B. The nurse flushed the client's IV line with dextrose 5% in water before and after the medication was administered:
Flushing the IV line with dextrose 5% in water is a standard practice before and after medication administration. This action helps ensure that the medication is effectively delivered and that the line remains patent. There is no indication of an error in this case.
C. The medication vial sat at room temperature for 2 hr before it was administered:
Filgrastim is a medication that typically requires refrigeration to maintain stability. Allowing it to sit at room temperature for an extended period can affect its efficacy and safety. This is a deviation from the recommended storage conditions and should be reported as an incident to assess potential consequences.
D. The client had chemotherapy 12 hr before the medication was administered:
This information does not necessarily suggest an incident related to the administration of filgrastim. The timing of chemotherapy is an essential consideration in cancer treatment protocols. Filgrastim is often administered to support recovery from the hematopoietic effects of chemotherapy.

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Correct Answer is D

Explanation

A. Urine specific gravity 1.020: While this value indicates concentrated urine and can be useful in assessing dehydration, it doesn’t specifically confirm effective treatment. High urine specific gravity suggests dehydration because the kidneys are conserving water, but it doesn’t directly confirm the effectiveness of treatment.
B. BUN 28 mg/dl (Blood Urea Nitrogen): Elevated BUN levels can be seen in dehydration, but it's not a direct marker of effective treatment. It indicates dehydration due to increased urea concentration in the blood but doesn’t confirm if the treatment has been effective or not.
C. Serum hematocrit 55%: In dehydration, the blood becomes more concentrated due to water loss, causing an increase in hematocrit levels. However, while this value might indicate dehydration initially, it may not specifically confirm the effectiveness of treatment once initiated.
D. Serum osmolarity 310 mOsm: Serum osmolarity measures the concentration of particles in the blood. In dehydration, the blood becomes more concentrated, leading to increased serum osmolarity. When treatment is effective, rehydration occurs, diluting the blood and bringing serum osmolarity back toward normal levels. Therefore, a decrease in serum osmolarity towards the normal range (280-300 mOsm) would indicate effective treatment of dehydration

A. "Limit your sodium intake. B. Avoid caffeinated beverages C. Take the medication with meals. D. Restrict milk products

Correct Answer is B

Explanation

A. Limit your sodium intake: While excessive sodium intake may be a concern for individuals with certain health conditions, there is no specific restriction on sodium intake associated with theophylline use. This instruction is not directly relevant to theophylline therapy.
B. Avoid caffeinated beverages (Correct Answer): Caffeine can increase the risk of theophylline toxicity by enhancing its effects. Theophylline is metabolized in the liver, and caffeine can interfere with this process. Therefore, it is advisable for individuals taking theophylline to avoid excessive consumption of caffeinated beverages.
C. Take the medication with meals: Theophylline is often prescribed on an empty stomach because food can decrease its absorption. However, the specific recommendation may vary based on the formulation of the medication. It is important to follow the healthcare provider's instructions regarding when to take theophylline in relation to meals.
D. Restrict milk products: There is no general restriction on milk products associated with theophylline use. However, it's important to note that high-fat meals may affect the absorption of theophylline, so individualized instructions from the healthcare provider should be followed.

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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?

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