The nurse is caring for a patient receiving chemotherapy who is admitted with an absolute neutrophil count (ANC) of 459 cells/ulu. The healthcare provider orders G-CSF (filgrastim). Which action will the nurse take to promote safe and effective use of filgrastim for this patient?

Monitor the patient's ANC daily and stop medication when the ANC is greater than 20,000 cells/ulu.

Teach the patient how to administer the medication via intramuscular.

Ensure the patient understands the risk of bone pain and how to manage it.

Administer filgrastim as needed for symptoms of infection.

Answer and Explanation

The Correct Answer is C

Choice A reason: Monitoring the patient's absolute neutrophil count (ANC) daily and stopping medication when the ANC is greater than 20,000 cells/uL is an essential aspect of using filgrastim safely. However, this is typically managed by the healthcare provider and not the primary action for the nurse to take for patient education. The nurse's role focuses more on educating the patient about potential side effects and self-care.

Choice B reason: Teaching the patient how to administer the medication via intramuscular is not relevant for filgrastim, as it is typically administered via subcutaneous injection. Proper administration technique is crucial for ensuring the medication's effectiveness, but this choice does not accurately reflect the standard administration method for filgrastim.

Choice C reason: Ensuring the patient understands the risk of bone pain and how to manage it is crucial for promoting safe and effective use of filgrastim. Bone pain is a common side effect of filgrastim due to the stimulation of bone marrow to produce more neutrophils. Educating the patient about this potential side effect and providing strategies for managing the pain, such as using over-the-counter pain relievers, helps improve patient comfort and adherence to the medication.

Choice D reason: Administering filgrastim as needed for symptoms of infection is not appropriate. Filgrastim is used to stimulate neutrophil production and prevent infection, rather than treating active infections. The medication should be administered according to the prescribed schedule, not based on the presence of infection symptoms.

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Correct Answer is B

Explanation

Choice A reason: Normal blood pressure and deep respirations do not necessarily indicate that hyperosmolar hyperglycemic syndrome is resolving. Deep respirations, also known as Kussmaul respirations, can occur in response to severe hyperglycemia.

Choice B reason: Increased alertness and a normal heart rhythm suggest that the patient's neurological status and cardiovascular system are stabilizing, which are positive indicators that the treatment is effective in managing hyperosmolar hyperglycemic syndrome.

Choice C reason: High urine specific gravity and normal temperature do not directly indicate the effectiveness of treatment for hyperosmolar hyperglycemic syndrome. High urine specific gravity can result from dehydration.

Choice D reason: A blood glucose level of 250 mg/dL with disorientation still indicates poorly controlled hyperglycemia and ongoing metabolic disturbance, which means the treatment is not yet effective.

A. Administer a rapid infusion of fluids. B. Increase the dialysis flow rate. C. Decrease the rate of dialysis. D. Apply ice packs to the patient's head. E. Monitor neurological status closely.

Correct Answer is ["C"]

Explanation

Choice A reason: Administering a rapid infusion of fluids is not appropriate for disequilibrium syndrome. This syndrome results from rapid changes in fluid and electrolyte balance during dialysis, and rapid fluid infusion could worsen the condition.

Choice B reason: Increasing the dialysis flow rate is not appropriate. Decreasing the rate of dialysis can help reduce the symptoms of disequilibrium syndrome by allowing the body to adjust more gradually.

Choice C reason: Decreasing the rate of dialysis helps to minimize the rapid shifts in fluid and electrolytes, which can exacerbate disequilibrium syndrome.

Choice D reason: Applying ice packs to the patient's head is not a standard intervention for disequilibrium syndrome. The focus should be on managing the rate of dialysis and monitoring the patient's neurological status.

Choice E reason: Monitoring neurological status closely is important because disequilibrium syndrome can cause symptoms such as headache, nausea, confusion, and seizures. Close monitoring allows for prompt intervention if symptoms worsen.

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The nurse is caring for a patient receiving chemotherapy who is admitted with an absolute neutrophil count (ANC) of 459 cells/ulu. The healthcare provider orders G-CSF (filgrastim). Which action will the nurse take to promote safe and effective use of filgrastim for this patient?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for a patient with hyperosmolar hyperglycemic syndrome. The patient is receiving intravenous fluids of normal saline with 20 mEq of potassium chloride and a continuous insulin infusion. Which finding will indicate to the nurse that the treatment is effective?

Correct Answer is B

Explanation

The nurse is caring for a patient who is experiencing disequilibrium syndrome during hemodialysis. Which of the following interventions will the nurse implement for this patient? (Select All That Apply)

Correct Answer is ["C"]

Explanation

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