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 A
Explanation
A. Rotate the application site every week (Correct Answer): This is the correct advice. Rotating the application site helps prevent skin irritation and enhances absorption. It's common practice to apply the patch to a different, clean, and hairless area of the skin each time it is changed.
B. The transdermal patch releases nicotine rapidly into the bloodstream: This statement is incorrect. The transdermal nicotine patch is designed to release nicotine gradually over an extended period. It provides a steady, controlled release of nicotine to help manage withdrawal symptoms and cravings.
C. Leave the patch in place for 8 hr each day: The specific duration for wearing a nicotine patch can vary depending on the product. However, it's generally recommended to wear the patch for 16 to 24 hours, depending on the product's instructions. Leaving it on for 8 hours only may not provide adequate coverage for the entire day.
D. The transdermal patch can cause insomnia: While insomnia is a potential side effect of nicotine replacement therapy, including the patch, it is not a universal experience for everyone. Insomnia is more likely to occur if the patch is worn continuously, including during the night. Following proper usage guidelines, such as removing the patch before bedtime, can help minimize this side effect.
Correct Answer is A
Explanation
A. Assess the client for adverse reactions:
After ensuring the client's safety and well-being, the nurse can then proceed with the other necessary actions, such as determining the factors that led to the omission, filing an incident report, and reporting the missed dosage to the client's provider. However, assessing the client for any immediate adverse reactions takes precedence to address any potential harm that may have resulted from the missed medication dose.
B. Determine factors that led to the omission:
This is the correct answer. Understanding the factors that led to the omission is crucial for preventing future errors. The nurse should assess if there were any system failures, distractions, or other factors contributing to the missed dose.However, patient's safety and wellbeing comes first.
C. File an Incident report:
Filing an incident report is an important step, but it should not be the first action. The nurse needs to address the immediate situation and assess the factors contributing to the omission first.
D. Report the missed dosage to the client's provider:
Reporting the missed dosage to the provider is an important step, but it should not be the first action. The nurse needs to address the immediate situation, assess the client, and determine factors leading to the omission before reporting to the provider.
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