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.
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Related Questions
Correct Answer is C
Explanation
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.
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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