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 B

Explanation

A. I will check the client's INR before administering the heparin:
Checking the International Normalized Ratio (INR) is more relevant for monitoring the effects of warfarin, not heparin. Heparin is typically monitored by activated partial thromboplastin time (aPTT) or anti-Xa levels.
B. "I will apply pressure for 1 minute after the injection:"
Applying gentle pressure to the injection site for about 1 minute after administering heparin is appropriate to prevent bleeding or bruising. Since heparin is an anticoagulant, there's an increased risk of bleeding at the injection site.
C. I will massage the site after injecting the heparin:
Massaging the site after injecting heparin is not recommended. It can increase the risk of hematoma formation. After subcutaneous injection, it is generally advised to avoid massaging the site.
D. I will aspirate before administering the heparin:
Aspiration is not recommended when administering heparin subcutaneously, as it can increase the risk of tissue damage and bruising. The nurse should inject the heparin without aspirating.

A. "You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease" B. "You will need to take two or more medications to treat your disease C. You should anticipate taking medication to treat your disease for at least the next 3 years D. You should report monthly to have your blood drawn to monitor kidney function while taking medication

Correct Answer is B

Explanation

A. "You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease."
Tuberculin skin tests are typically used for screening and diagnosis, not for monitoring the effectiveness of tuberculosis treatment. Monitoring for treatment effectiveness involves assessing symptoms, sputum cultures, and other diagnostic tests.
B. "You will need to take two or more medications to treat your disease."
This is the correct answer. Tuberculosis is usually treated with a combination of antibiotics to prevent the development of drug resistance. Multidrug therapy is a standard approach to tuberculosis treatment.
C. "You should anticipate taking medication to treat your disease for at least the next 3 years."
The duration of tuberculosis treatment is generally shorter than 3 years. The standard treatment duration is typically 6 to 9 months, depending on the specific regimen used.
D. "You should report monthly to have your blood drawn to monitor kidney function while taking medication."
Monitoring kidney function is important for some medications, but it is not a standard monthly requirement for tuberculosis treatment. Monitoring typically involves assessing liver function, as certain tuberculosis medications can affect the liver.

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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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