A nurse is caring for a client who is receiving filgrastim. The nurse should monitor the client for which of the following adverse effects?

Choice A rationale Fluid retention is not a common or primary adverse effect associated with filgrastim. Filgrastim stimulates granulocyte production and is generally well-tolerated with specific side effect profiles that do not typically include significant fluid accumulation or edema. Other medications or conditions are more commonly associated with fluid retention. Choice B rationale Hypertension, or elevated blood pressure, is not a frequently reported or significant adverse effect of filgrastim. While any medication can potentially affect blood pressure, filgrastim's primary mechanism of action (stimulation of neutrophil production) does not directly or commonly lead to sustained increases in blood pressure. Choice C rationale Bone pain is a very common and well-documented adverse effect of filgrastim. This pain is believed to result from the rapid proliferation and expansion of hematopoietic cells within the bone marrow, which is stimulated by filgrastim. The pain is typically mild to moderate and is managed with analgesics. Choice D rationale Hypokalemia, or low serum potassium, is not a typical adverse effect of filgrastim. Filgrastim does not directly influence potassium balance or renal function in a way that would lead to a decrease in serum potassium levels. Electrolyte imbalances are not commonly associated with its use.