A client with preexisting bipolar disorder is receiving ...

[renzo156]

A client with preexisting bipolar disorder is receiving filgrastim (Neupogen) for the management of neutropenia following chemotherapy treatments for lymphocytic leukemia.
 
  The oncology nurse recognizes that which preparation for bipolar disorder could complicate the management of the client's leukemia?
  1. Clonazepam (Klonopin)
  2. Valproic acid (Depakene)
  3. Carbamazepine (Tegretol)
  4. Lithium carbonate

Question 2

A client is prescribed a dose of oprelvekin. Prior to administration of the drug, which nursing assessment should trigger a telephone call to the provider who wrote the order?
 
  1. Current platelet count of 25,000
  2. History of myelogenous leukemia
  3. History of alcohol abuse
  4. Current hemoglobin of 9.6 gm/dL

[ilianabrrr]

Answer to Question 1

Correct Answer: 4
Rationale 1: Clonazepam does not interact with filgrastim.
Rationale 2: Valproic acid does not interact with filgrastim.
Rationale 3: Carbamazepine does not interact with filgrastim.
Rationale 4: Lithium has a synergistic effect when administered concomitantly with filgrastim.
Global Rationale: Lithium has a synergistic effect when administered concomitantly with filgrastim. Clonazepam, valporic acid, and carbamazepine do not interact with filgrastim.

Answer to Question 2

Correct Answer: 2
Rationale 1: A platelet count of 25,000 is low, and the order is appropriate.
Rationale 2: Myelogenous leukemia is a contraindication for oprelvekin therapy.
Rationale 3: Liver disease calls for caution during the administration of oprelvekin, but it is not a contraindication. The order is appropriate.
Rationale 4: A hemoglobin of 9.6 gm/dL is too low and is not a contraindication for oprelvekin. The order is appropriate.
Global Rationale: Myelogenous leukemia is a contraindication for oprelvekin therapy. A platelet count of 25,000 is low, and the order is appropriate. Liver disease calls for caution during the administration of oprelvekin, but it is not a contraindication. The order is appropriate. A hemoglobin of 9.6 gm/dL is too low and is not a contraindication for oprelvekin. The order is appropriate.

[renzo156]

Excellent

[tranoy]

TYSM