Patho Exam 4 PrepU

A client is receiving ferrous sulfate as treatment for iron deficiency anemia. After teaching the client, which statement indicates the need for additional teaching?

"I need to take an antacid with the pill to prevent an upset stomach."

The average lifespan of a red blood cell (RBC) is approximately:

120 days.

A client is receiving anticoagulant therapy and has an INR done. Which result would the nurse interpret as being therapeutic?

2.4

A client is receiving epoetin alfa. The nurse understands that this drug's duration of effect would be which amount of time?

24 hours

A nurse will use extreme caution when administering heparin to which patient?

A 38-year-old male with peptic ulcer disease

Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy?

A 62-year-old male with cancer

Which nursing diagnosis would provide the most plausible indication for the use of epoetin alfa in a client with renal failure?

Activity intolerance related to decreased oxygen-carrying capacity

A hospital patient in a critical care setting is currently receiving an intravenous infusion of aminocaproic acid. What desired outcome is paramount in the care of this patient?

Adequate tissue perfusion will be maintained

A client with a diagnosis of renal failure is being treated for anemia with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment?

CBC

The client is a woman 65 years of age being treated for anemia secondary to chronic kidney disease. The nurse explains to the client that she will be getting a prescription for Epogen. Which of the following additional information would the nurse provide?

Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.

A patient is to be administered an erythropoiesis-stimulating agent. Which of the following drugs would the nurse administer?

Epoetin alfa

In acute coronary syndrome (unstable angina, MI), platelet aggregation must be inhibited before medical or surgical treatment begins. Which medication exhibits antiplatelet effects during infusion that ceases when the infusion is stopped?

Eptifibatide

A patient who is HIV positive is receiving zidovudine 4,2000 mg/week and has an endogenous erythropoietin level of 350 mU/mL. What does the nurse anticipate will be administered for this patient?

Erythropoietin

Which would a nurse identify as inhibiting factor Xa?

Fondaparinux

Deficiencies in folic acid are noticed first in rapidly growing cells, such as those in which areas? (Select all that apply.)

Gastrointestinal (GI) tract Bone marrow Cancerous tissues

Which genetic clinical condition will likely, over the course of the client's lifetime, require the pharmaceutical introduction of clotting factors to assure the client's safety?

Hemophilia

Protamine is used to treat overdose of which medications? (Select all that apply.)

Heparin Enoxaparin (Lovenox)

A client is diagnosed with sickle cell anemia. Which agent would the nurse expect to be ordered?

Hydroxyurea

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?

Impaired tissue oxygenation related to anemia

A 59-year-old client with vascular disorders is prescribed cilostazol. The nurse instructs the client that it is for the treatment of what condition?

Intermittent claudication

Adverse effects of epoetin and darbepoetin include increased risks of what condition?

Myocardial infarction

A 75-year-old client presents to the health care provider's office with bleeding gums and multiple bruises. When the nurse reviews the client's drug history, the nurse finds that the client is prescribed aspirin 81 mg/d. What drug may cause increased bleeding when used in conjunction with the aspirin?

NSAIDs

A client is receiving warfarin. The nurse would expect to administer this drug by which route?

Oral

A client is taking warfarin to prevent clot formation related to atrial fibrillation. How are the effects of the warfarin monitored?

PT and INR

A nurse is preparing to administer epoetin alfa to a client. Which tests should the nurse review prior to administration? Select all that apply.

Red blood cell (RBC) count Hemoglobin

A patient has been prescribed epoetin alfa. The nurse recognizes that this medication is indicated for treatment of anemia associated with which disease process?

Renal failure

A client is being sent home with subcutaneous heparin after a total hip replacement. The nurse understands what symptom would indicate a serious drug reaction?

Tarry stools

Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which fact should underlie the nurse's response to Mr. Lepp?

The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.

A male client is taking Procrit. He requests changing his medication from the IM to the PO route. The nurse's best response is:

This medication is destroyed in the stomach and can only be given IM.

A male client is diagnosed with severe neutropenia and is prescribed filgrastim. What is the desired effect?

To increase white blood cells

When describing the clotting process, which step would the nurse identify as the first reaction to occur with injury to a blood vessel?

Vasoconstriction

A male client is prescribed interferon. What is his probable diagnosis?

Viral hepatitis

Which client would likely be the most appropriate candidate for treatment with filgrastim?

a client whose acute myelogenous leukemia necessitated a bone marrow transplant

The nurse will appraise the success or failure of treatment of filgrastim therapy by regularly monitoring the results of what diagnostic test?

absolute neutrophil count

A client, taking warfarin after open heart surgery, tells the home care nurse she has pain in both knees that began this week. The nurse notes bruises on both knees. Based on the effects of her medications and the report of pain, what should the nurse suspect is the cause of the pain?

bleeding

A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client's condition closely. When taking the client's vital signs, the nurse should pay particular attention to what assessment datum?

blood pressure

A client who is recovering in hospital from a bilateral mastectomy has developed minor bleeding at one of the incision sites. During the process of clot formation, plasminogen will become part of a clot by which means?

by binding with fibrin

The provider orders heparin for a 35-year-old female client. The nurse administers the drug only after confirming that the client:

does not have peptic ulcer disease.

A client has been diagnosed with genital warts. Which medication would the nurse anticipate being prescribed?

interferon alfa-2b

A client with a history unstable angina is being prepared for percutaneous transluminal coronary angioplasty (PTCA). The nurse assessing the client should focus on identifying a history of which conditions/situations that are considered contraindications to this procedure? Select all that apply.

major trauma within the last 6 weeks uncontrolled hypertension thrombocytopenia

A client is being treated with heparin therapy for a pulmonary embolism. The nurse caring for this client knows that heparin:

prevents the extension of the clot that has formed in lungs

A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to:

schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks

A client who is undergoing chemotherapy for the treatment of non-Hodgkin's lymphoma will soon begin treatment with epoetin alfa. The nurse should be aware that this drug may be administered by which route? Select all that apply.

subcutaneous intravenous

A client, currently prescribed epoetin alfa, has recent blood work that reveals a hemoglobin level of 12.8 g/dL. What action does this assessment finding necessitate regarding the epoetin alfa?

temporarily withholding administration

The component of the red blood cell that is not recycled is bilirubin.

true

After teaching a patient about the adverse effects of iron therapy, the patient demonstrates understanding of the information when the patient identifies what adverse effects? (Select all that apply.)

Anorexia Dark stools Constipation

A client prescribed an anticoagulant demonstrates an understanding of their condition by implementing which interventions to manage an episode of bleeding? Select all that apply.

Apply firm, constant pressure to the bleeding site. Notify a health care provider immediately.

A 61-year-old man is prescribed alteplase for an acute myocardial infarction. A priority nursing intervention will be to monitor for what during and after drug therapy?

Arrhythmias

A client is receiving heparin. Which would the nurse use to monitor the effects of the drug?

Partial thromboplastin time

After teaching a group of students about the types of anemia, the instructor determines that the teaching was successful when the students identify which anemia results from an inability to produce the intrinsic factor?

Pernicious anemia

After reviewing the drugs that may interfere with warfarin, the students indicate that they need additional study when they identify what as requiring a dosage increase in the warfarin?

Phenytoin

A client exhibits signs and symptoms of heparin overdose. The nurse would anticipate administering:

Protamine sulfate

A nurse is caring for a 64-year-old female client who is receiving IV heparin and reports bleeding from her gums. The nurse checks the client's laboratory test results and finds that she has a very high aPTT. The nurse anticipates that which drug may be ordered?

Protamine sulfate