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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "You should take this medication on an empty stomach:"
Bumetanide can be taken with or without food. It is not necessary to take it on an empty stomach.
B. "You should monitor for hearing difficulties:"
This is the correct answer. Loop diuretics, including bumetanide, are associated with ototoxicity, which can lead to hearing difficulties or hearing loss. Clients should be instructed to report any changes in hearing.
C. "You should decrease your intake of foods high in potassium:"
Bumetanide can cause potassium loss, but instructing the client to decrease potassium intake may not be appropriate without knowing the client's specific potassium levels. Monitoring potassium levels and adjusting the diet or prescribing supplements as needed would be a more individualized approach.
D. "You should take the medication at bedtime:"
Bumetanide is often prescribed in the morning to avoid disrupting sleep with increased urination during the night. Taking it at bedtime is not a typical recommendation.
Correct Answer is D
Explanation
A. INR 1.0: The International Normalized Ratio (INR) is a measure of blood clotting. A value of 1.0 is within the normal range, so there is no immediate concern related to furosemide administration based on this INR value.
B. WBC count 8,000/mm³: The white blood cell count is not directly related to furosemide administration, and the value of 8,000/mm³ is within the normal range. There is no immediate concern based on this WBC count.
C. Sodium 141 mEq/L: The sodium level is within the normal range, and it is not a contraindication for furosemide administration.
D. Potassium 2.5 mEq/L: A potassium level of 2.5 mEq/L is significantly below the normal range. Furosemide is a loop diuretic that can lead to potassium loss, and administering it when the potassium level is already low can further decrease potassium levels, potentially leading to serious complications such as cardiac arrhythmias. Therefore, the nurse should withhold the medication and contact the provider to address the low potassium level before administering furosemide.
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