The nurse is preparing to give sargramostim to a patient who has ...

[ts19998]

The nurse is preparing to give sargramostim to a patient who has acute myelogenous leukemia (AML). The nurse assesses a heart rate of 78 beats per minute and a blood pressure of 120/70 mm Hg.
 
  The patient reports shortness of breath and has a cough and bilateral crackles. What will the nurse do next?
  a. Contact the provider; discuss giving a lower dose.
  b. Contact the pharmacist; request a bronchodilator.
  c. Contact the pharmacist; request an order for furosemide.
  d. Contact the provider; suggest administration of antibiotics.

Question 2

A patient is receiving bone marrow transplantation for cancer and receives filgrastim (Neupogen). The patient reports abdominal pain in the left upper quadrant. The nurse will perform which action?
 
  a. Administer acetaminophen 650 mg.
  b. Administer an antiemetic medication.
  c. Report a potentially life-threatening event.
  d. Request an order for cardiac enzyme levels.

[stallen]

Answer to Question 1

ANS: A
Patients receiving this drug can experience sequestration of granulocytes in the pulmonary circulation and may experience dyspnea. The sargramostim infusion should be reduced in half if this occurs. Bronchospasm, pulmonary edema, and infection are not common side effects.

Answer to Question 2

ANS: C
Splenic rupture can occur with this drug and is manifested by pain in the left upper quadrant. The nurse should report the abdominal pain to the provider so the patient can be evaluated for splenic rupture.

[ts19998]

Thanks for the timely response, appreciate it

[raenoj]

Gracias!