A patient with lung cancer receives filgrastim [Neupogen] after chemotherapy to reduce neutropenia. The patient reports a moderate degree of bone pain. What will the nurse do?
a. Obtain an order to administer acetamino-phen.
b. Request an order for a complete blood count (CBC).
c. Request an order to reduce the dose of filgrastim.
d. Suspect metastasis of the cancer to the bone.
A
Bone pain occurs in about 25% of patients receiving filgrastim. It can be treated with a nonopioid analgesic and, if necessary, an opioid analgesic. Leukocytosis can occur, but bone pain is not a symptom of this, so a CBC is not indicated. Bone pain is not an indication for reducing the dose of filgrastim. Because moderate bone pain is a common adverse effect, metastasis to the bone is less likely.
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