Which nursing interventions should be implemented when a patient is on Filgrastim?

Which nursing interventions should be implemented when a patient is on Filgrastim?

• A. Monitor for hypoglycemia
• B. Assess for fluid overload
• C. Monitor for leukocytosis, bone pain, and splenomegaly
• D. Check for electrolyte imbalance

Answer: (C)

Filgrastim is a granulocyte colony-stimulating factor that prompts the bone marrow to produce neutrophils. Because of this action, the main nursing focus is on effects related to increased neutrophil production. The best-supported nursing interventions are to monitor for leukocytosis, bone pain, and splenomegaly. Leukocytosis occurs as neutrophil counts rise quickly, so you’d regularly check the complete blood count to track WBC and neutrophil levels and watch for counts that are too high. Bone pain is a common adverse effect from the marrow’s heightened activity, so assessing pain and providing appropriate analgesia or dose adjustments helps the patient stay comfortable. Splenomegaly can occur because of extramedullary hematopoiesis, so assess for signs of abdominal fullness or left upper-quadrant discomfort and counsel the patient to report new abdominal pain or fullness. These are the key considerations; other options like hypoglycemia, fluid overload, or electrolyte imbalance are not typical nursing priorities with filgrastim.

Filgrastim is a granulocyte colony-stimulating factor that prompts the bone marrow to produce neutrophils. Because of this action, the main nursing focus is on effects related to increased neutrophil production. The best-supported nursing interventions are to monitor for leukocytosis, bone pain, and splenomegaly. Leukocytosis occurs as neutrophil counts rise quickly, so you’d regularly check the complete blood count to track WBC and neutrophil levels and watch for counts that are too high. Bone pain is a common adverse effect from the marrow’s heightened activity, so assessing pain and providing appropriate analgesia or dose adjustments helps the patient stay comfortable. Splenomegaly can occur because of extramedullary hematopoiesis, so assess for signs of abdominal fullness or left upper-quadrant discomfort and counsel the patient to report new abdominal pain or fullness. These are the key considerations; other options like hypoglycemia, fluid overload, or electrolyte imbalance are not typical nursing priorities with filgrastim.