hematologic system

Clopidogrel contraindications

hemophilia, bleeding disorders, peptic ulcer disease, thrombocytopenia, IC bleeding

A nurse is administering epoetin IV to a client who has renal failure. Which of the following actions should the nurse take? a. Shake the vial before using. b. administer via IV bolus over 1 to 3 min c. Dilute the drug first with D5W d. Save the used vial for the next dose

Administer via IV bolus over 1 to 3 min mix with 0.9NaCl only, discard if cloudy/discolored, only use once and then discarding it

a nurse is preparing to administer a prescribed dose of desmopressin to a client who has hemophilia A. The client's laboratory results indicate that the client has a sodium level of 130. Which of the following actions should the nurse take? a. Clarify the prescription with the provider. b. administer the drug with an analgesic c. administer the required dose orally. d. assess factor IX levels

Clarify the prescription with the provider filgrastim - bone pain Desmopressin is administered IV or nasally, treats hemorrhages A only

a nurse is caring for a client who is about to begin therapy with recombinant factor IX to treat hemophilia B. The client asks the nurse about the risk of disease transmission with recombinant factor IX as compared with plasma derived factor IX. The nurse should explain the recombinant factor IX practically elminates the risk for which of the following? a. HIV b. cytomegalovirus c. Creutzfeldt-Jakob disease D. Anaphylaxis

Creutzfeldt-Jakob disease - prion transmitted infection plasma derived products carry a minimal risk of acquiring hep A and parvovirus B19

a nurse is caring for a client who is about to begin taking epoetin . an increase in which of the following lab values should indicate to the nurse that the therapy is effective? a PT b WBC c Hgb D Platelets

Hgb Increased platelets can indicate thrombocytosis Stimulates RBCs

A nurse is teaching a client about taking ferrous sulfate to treat iron deficiency anemia. which of the following instructions should the nurse include? Iron riches foods spread dosage across day take the drug on empty stomach report dark green/black stools increase fiber intake

Iron enriched foods spread dosage across each day take drug on empty stomach increase fiber intake

A nurse is caring for a client who is about to begin taking folic acid to treat megaloblastic anemia. The nurse should monitor which of the following lab values to determine therapeutic effectiveness? a. amylase level b. reticulocyte count c. c-reactive protein d. creatinine clearance

Reticulocyte count - amount of immature RBCs, essential for erythropoiesis.

A nurse should assess a client who has megaloblastic anemia for indications of which of the following vitamin deficiencies?

Vitamin B12

a nurse is caring for a client who has renal failure and is receiving epoetin. the nurse should monitor the client for which of the following adverse effects? a. HTN b. muscle pain c. edema d. dry mouth

a. HTN adverse effects also in CV and nervous system

a nurse is caring for a client who has chronic stable angina. the nurse should identify that which of the following drugs inhibits the action of adenosine diphosphate receptors (ADP) on platelets and can be prescribed to reduce the client's risk for myocardial infarction? a. clopidogrel b. heparin c. warfarin d. alteplase

a. clopidogrel - prevents platelet aggregation, blocks ADP receptors heparin - prevents formation of fibrin warfarin - inhibits VK preventing its activation alteplase - thrombolytic drug

Clopidogrel action

blocks adenosine disphosate receptor agonists

a nurse is reviewing the medication record of a client who is receiving aleplase following an acute myocardial infarction (MI). Which of the following medications should the nurse expect the client to be taking in addition to the alteplase? a. protamine b. desmopressin c. ferrous sulfate d. heparin

heparin - should be initiated before alteplase therapy for at least 48-72 hrs desmopressin - ppl who have hemophilia A Ferrous sulfate - iron deficiency protamine - reverses heparin

Clopidogrel adverse effects

hypercholesterolemia

Filgrastim adverse effects

hyperuricemia

Desmopressin adverse effect

hyponatremia

Action of warfarin

inhibits clotting factors by limiting the production of clotting factors VII, IX, X and PT

a nurse is caring for a client who is experiencing an acute ischemic cerebrovascular event due to a thrombus in a cerebral vessel. Which of the following drugs should the nurse expect to administer? a. alteplaase b. aspirin c. clopidogrel d. heparin

Alteplase - dissolves clots related to CV event

a nurse is caring for a client who is scheduled for an outpatient surgical procedure and reports taking aspirin 81 mg daily, including this morning. the nurse should identify that this places the client at risk for which of the following complications? a. uncontrolled bleeding b. myocardial infarction c. respiratory depression d. decreased renal perfusion

a. uncontrolled bleeding aspirin - causes GI distress

a nurse is caring for a client who is about to begin alteplase therapy to treat pulmonary embolism. which of the following drugs should the nurse have available in the event of a severe adverse reaction? a. VK B. aminocaproic acid c. protamine d. deferoxamine

b. aminocaproic acid - inhibits bleeding protamine - heparin VK - warfarin Deferoxamine - iron toxicity

A nurse is caring for a client who recently started alteplase therapy. The nurse should monitor the client for which of the following adverse effects? a. bronchodilation b. headache c. edema d. HTN

b. headache also causes bronchospasm, hypotension with bleeding

a nurse is monitoring a client following ferrous sulfate administration. the nurse should monitor the client for which of the following adverse effects? a. phlebitis b. dark, organe stools c. constipation d. injection site pain

constipation oral supplementation is associated with constipation, dark green/black stools

A nurse is caring for a client who is taking clopidogrel to prevent stent restenosis. The nurse should monitor the client for which of the following adverse effects? a. hyperuricemia b. hyponatremia c. lymphocytopenia d. thrombocytopenia

d. thrombocytopenia

a nurse is caring for a client who is taking ferrous sulfate to treat iron deficiency anemia and develops iron toxicity. which of the following drugs should the nurse expect to use to treat this complication a. flumazenil b. acetylcysteine c. naloxone d. deferoxamine

deferoxamine

a nurse is teaching a client who is starting treatment with warfarin. the nurse should plan to include information on which of the following topics to promote the effectiveness of the drug? a. sleep modifications b. fluid modifications c. driving modifications d. dietary modifications

dietary modifications

a nurse is caring for a client who has hemophilia A and is about to begin taking desmopressin to prevent bleeding. the nurse should monitor the client for which of the following adverse reactions? a. weight loss b. edema c. polyuria d. bradycardia

edema desmopressin can cause fluid retention and edema, hyponatremia, weight gain, reduce urine output, tachycardia, increase in BP

Oprelvekin adverse effects

edema and fluid rentention

a nurse is caring for a client who is taking filgrastim to treat neutropenia. the nurse should assess the client for which of the following adverse effects? a. dusky nail beds b. petechiae c. enlarged spleen d. swollen calf

enlarged spleen - long term use can cause enlarged spleen, leukocytosis, fever, bone pain, and ECG changes

a nurse is caring for a client who is about to begin aspirin to reduce the risk of a CV event. the nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms? a. activating thromaxne A2 b. blocking adenosine diphosphate receptor agonists c. suppressing specific clotting factors d. inhibiting clyooxygenase action in platelets

inhibiting cyclooxygenase action in platelets

s/s of hemorrhage

pallor of sclera, skin, mucous membrane, visible brusing/petechia black tarry stools

A nurse should identify that clopidogrel is contraindicated for clients who have which of the following conditions? a. myocardial infarcation b. peptic ulcer disease c. pancreatitis d. myasthenia gravis

peptic ulcer disease clients who have peptic ulcer disease snould not take clopidogrel bc it can cause gastric bleeding

a nurse is monitoring a client who is undergoing anticoagulant therapy with heparin. which of the following findings should the nurse identify as a possible indication of hemorrhage? a. rapid pulse b. yellowing of the sclera c. elevated BP d. pale colored stools

rapid pulse blood loss - hypotension, rapid pulse

a nurse in an ED is assessing a client who has been taking warfarin and is experiencing rectal bleeding. Which of the following drugs should the nurse expect to administer to the client? a. filgrastim b. deferoxamine c. protamine d. VK

vitamin K

a nurse is caring for a client who is about to begin factors VIII therapy to treat hemophilia A. When administering factor VIII, which of the following actions should the nurse take? a. administer the powdered form orally b. premeditate with aspirin c. administer it via rapid IV bolus d. have emergency equipment ready

Have emergency equipment ready administer slowly over 5-10 min, aspirin is contraindicated, powdered form is dissolved