Pharm Ch 49 Drugs Used to Treat Anemias

The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. Which statement is true about the cause of anemia? "Anemia is a condition caused by reduced amounts of protein, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of hematocrit, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of platelets, causing less oxygen to be delivered to the tissues." "Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."

"anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."

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? AST CBC C-reactive protein ALT

CBC

A client with iron deficiency anemia has begun taking daily supplements of oral ferrous sulfate. The nurse should add what nursing diagnosis to the nursing care plan? Risk for peripheral neurovascular dysfunction related to use of iron supplements Risk for constipation related to use of iron supplements Risk for unstable blood glucose related to use of iron supplements Risk for excess fluid volume related to use of iron supplements

risk for constipation related to use of iron supplements

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

true

A client is prescribed oral ferrous sulfate solution. Which statement by the client indicates that the client understands how to take the drug? "I can mix the dose with a small amount of yogurt to make it taste better." "I should drink a big glass of water after swallowing the solution." "I should drink the solution through a straw so my teeth don't get stained." "I'll mix the dose with orange juice to make it easier to swallow."

"I should drink the solution through a straw so my teeth don't get stained."

A patient has been receiving intramuscular injections of hydroxocobalamin as treatment for pernicious anemia. Which statement by the patient indicates that he understands the therapy? "I need the injections now, but then I can switch to a pill." "I will need these injections monthly for the rest of my life." "Once my levels are up, I won't need the drug anymore." "I will get the injection for a week and then stop."

"I will need these injections monthly for the rest of my life."

A client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. When the nurse is assessing for therapeutic effects, what question is most warranted? "Do you feel like you're able to see a bit more clearly now?" "Is your skin feeling itchy when you're at rest?" "How is your energy level compared with a few days ago?" "Are you having any leg spasms or restless legs at night?"

"how is your energy level compared with a few days ago?"

A client prescribed epoetin alfa asks how the medication works. Which is the nurse's bestresponse? "Releases erythropoiesis from the kidneys to increase the number of platelets." "Stimulates the growth and development of white blood cells (WBC) to prevent neutropenia." "Increases the release of cells to increase the hemoglobin and hematocrit levels." "Decreases release of reticulocytes, which inhibits red blood cell (RBC) production."

"increases the release of cells to increase the hemoglobin and hematocrit levels."

The nurse would contact the prescriber immediately if interferon was prescribed for which client? 48-year-old female with hepatitis C 72-year-old male with AIDS-related Kaposi's sarcoma 34-year-old male with chronic hepatitis B 11-month-old female with HIV acquired from her mother

11-month-old female with HIV acquired from her mother

The nurse is preparing to administer an erythropoiesis-stimulating drug. The nurse checks the patient's chart, with the knowledge that the drug should not be administered to a patient with a target hemoglobin above which value? 8 mg/dL 10 mg/dL 14 mg/dL 12 g/dL

12 g/dL

The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician's attention prior to administering the medication? Hypothyroidism Diabetes mellitus Uncontrolled hypertension Osteoarthritis

uncontrolled hypertension

A male client is prescribed interferon. What is his probable diagnosis? Sepsis Hypertension Bacteremia Viral hepatitis

viral hepatitis

A patient has pernicious anemia. The nurse understands that this patient cannot absorb which vitamin? Vitamin B6 Vitamin B12 Vitamin D Vitamin C

vitamin b12

The nurse is reviewing the diet of a patient with folic acid deficiency. What would the nurse identify as a poor choice for increasing folic acid in the diet? Eggs Liver Yellow vegetables Milk

yellow vegetables

A client's current medical condition is suggestive of impaired erythropoiesis. Which laboratory study would be most clinically relevant in diagnosing this health problem? INR and aPTT RBC, hemoglobin, and hematocrit White blood cell count with differential D-dimer and C-reactive protein

RBC, hemoglobin, and hematocrit

Which client would likely be the most appropriate candidate for treatment with filgrastim? A client who developed acute renal failure secondary to rhabdomyolysis A client with acquired immune deficiency syndrome (AIDS) who has been diagnosed with Kaposi's sarcoma A client who has undergone a mastectomy for the treatment of breast cancer A client whose acute myelogenous leukemia necessitated a bone marrow transplant

a client whose acute myelogenous leukemia necessitated a bone marrow transplant

Which nursing diagnosis would provide the most plausible indication for the use of epoetin alfa in a client with renal failure? Ineffective breathing pattern related to inadequate erythropoietin synthesis Powerlessness-related sequelae of renal failure Activity intolerance related to decreased oxygen-carrying capacity Risk for infection related to decreased erythropoiesis

activity intolerance related to decreased oxygen-carrying capacity

A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition? hypertension hypoglycemia thrombocytopenia anemia

anemia

The prototype drug used to create red blood cells (RBCs) is epoetin alfa (Epogen, Procrit). It has many indications for use. Which are selected indications? Select all that apply. Anemia related to chemotherapy in patients with cancer Anemia from chronic renal disease (CRD) Anemia related to zidovudine therapy in HIV-associated illness Thrombocytopenia from chemotherapy Neutropenia due to chemotherapy SUBMIT ANSWER

anemia related to chemotherapy in patients with cancer anemia from chronic renal disease (CRD) anemia related to zidovudine therapy in HIV-associated illness

The nurse is doing patient teaching with a 30-year-old gravida 1 who has sickle cell anemia. She is not currently in crisis. Providing education on which topic is the highest nursing priority? Constipation prevention Iron-rich foods Control of pain Avoidance of infection

avoidance of infection

Which would be appropriate for a client who is receiving iron therapy? Advising the client to limit the amount of fiber in his diet Ensuring that the client consumes three large meals per day Cautioning the client that stool may be dark or green Encouraging the client to take the drug on an empty stomach

cautioning the client that stool may be dark or green

While reviewing a client's the record, the nurse sees that the client received a dose of interferon alpha-2b? For what disorder does the nurse suspect the client was being treated? ankylosing spondylosis bacterial pneumonia asthma chronic hepatitis C

chronic hepatits C

A client who was diagnosed with iron deficiency anemia is worried because she does not know why she was prescribed iron supplements. The nurse teaches the client about which action of oral iron administration? Iron supplements prevent depletion of hemoglobin cells from anxiety to treat anemia. Iron supplements prevent bleeding to replenish hemoglobin cells faster to treat anemia. Iron supplements prevent infection so hemoglobin cells grow back faster to treat anemia. Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia.

iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia

A patient comes to the clinic reporting fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse suspects that the patient will be diagnosed with: hemolytic anemia. sickle cell anemia. iron deficiency anemia. pernicious anemia.

iron deficiency anemia

A client with chronic kidney disease has been receiving epoetin alfa subcutaneous injections and has a hemoglobin level of 9.9 g/dl (99 g/L). Which treatment would the nurse anticipate being prescribed when the client reports new-onset fatigue? progressive activity program low-dose stimulant medication oxygen therapy iron supplements

iron supplements

When describing the function of vitamin B12, what would be appropriate to include? Maintenance of myelin sheath Oxygen transport to the tissues Prevention of neural tube defects Important role in cell division

maintenance of myelin sheath

A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order? Epoetin alfa Penicillin Filgrastim Interferon gamma

epoetin alfa

A patient is to be administered an erythropoiesis-stimulating agent. Which of the following drugs would the nurse administer? Epoetin alfa Hydroxyurea Ferrous sulfate Folic acid

epoetin alfa

A client is diagnosed with sickle cell anemia. Which agent would the nurse expect to be ordered? Ferrous sulfate Hydroxyurea Iron dextran Epoetin alfa

hydroxyurea

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa? Impaired tissue oxygenation related to anemia Alteration in nutrition due to poor intake of iron Altered skin integrity due to the disease process Alteration in bowel elimination due to side effects of the medication

impaired tissue oxygenation related to anemia

A nurse administers erythropoietin. What assessment finding is attributable to the increased effect of this hormone? Select all that apply. Decreased oxygenation in the bloodstream Increased red blood cell count Increased urinary output Anemia Increased hemoglobin

increased red blood cell count increased hemoglobin

A client is prescribed iron therapy using iron dextran. The nurse would administer this drug by which route? Oral Subcutaneous Intravenous Intramuscular

intramuscular

A client with chronic renal failure is prescribed to begin subcutaneous epoetin alfa injections. Which laboratory value will the nurse ensure is measured before starting the medication? serum potassium serum glucose serum ferritin serum albumin

serum ferritin

After reviewing the major types of anemia, students demonstrate understanding of the information when they identify what as an example of a hemolytic anemia? Pernicious anemia Iron deficiency anemia Folic acid deficiency anemia Sickle cell anemia

sickle cell anemia

An older adult client diagnosed with chronic renal failure has begun experiencing increasing fatigue. The nurse would anticipate educating the client on what likely medication prescription? penicillin G interferon gamma epoetin alfa filgrastim

epoetin alfa

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 A blood transfusion An increased dose of zidovudine Rocephin 1 GM IV

erythropoietin

The mature red blood cell contains a nucleus. True False

false

A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective? The patient maintains an oxygen saturation of 92% on room air The patient's hemoglobin level is 11 g/dL Capillary refill in the patient's nail beds is less than or equal to 3 seconds The patient white blood cell level is within reference ranges

the patient's hemoglobin level is 11 g/dL

A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond? This medication causes severe diarrhea if given orally. This medication is destroyed in the stomach and can only be given by injection. The oral route is not as effective. The drug dose must be increased if being given via the oral route.

this medication is destroyed in the stomach and can only be given by injection

Sickle cell anemia is an inherited disorder marked by the characteristic sickling of red blood cells. What are triggers of an episode of sickling? Select all that apply. acute infections immune response heat inflammatory responses alkalosis

acute infections immune response inflammatory responses

The nurse is teaching a client about folinic acid rescue in chemotherapy. Which of the following information would the nurse include in the teaching plan? Folinic acid rescue in chemotherapy includes leucovorin administration. Folinic acid rescue in chemotherapy includes Lipitor administration. Folinic acid rescue in chemotherapy includes Levophed administration. Folinic acid rescue in chemotherapy includes levothyroxine administration.

folinic acid rescue in chemotherapy includes leucovorin administration

Colony-stimulating factors (CSF) are administered to produce which therapeutic effect? Enhance immune system functioning Reduce side effects to a medication Increase the growth of specific types of blood cells Decrease the patient's reaction to a chemotherapeutic medication

increased the growth of specific types of blood cells

A client is receiving hydroxocobalamin for treatment of pernicious anemia. The nurse would administer this agent by which route? Intramuscular Oral Intravenous Subcutaneous

intramuscular

A nurse preparing to administer an erythropoiesis-stimulating drug is aware that the drug can be given by which routes? Select all that apply. Intravenous (IV) Oral Subcutaneous Transdermal Intradermal

intravenous (IV) Subcutaneous

Adverse effects of epoetin and darbepoetin include increased risks of what condition? Hyperlipidemia Myocardial infarction Diabetes mellitus type 2 Cirrhosis of the liver

myocardial infarction

After teaching a group of students about therapy for iron toxicity, the instructor determines that the students need additional teaching when they identify that the antidote can be administered by which route? Intramuscular Subcutaneous Oral Intravenous

oral

Nursing students are reviewing the anatomy and physiology of the hematopoietic system. Which would they correctly identify as the formed elements of blood? (Select all that apply.) Platelets Plasma Nerve cells Leukocytes Erythrocytes

platelets leukocytes erythrocytes

A student nurse is caring for a client who is receiving a hematopoietic agent. To test the student's understanding, the nursing instructor states that the drug could be administered by what route? Oral only Subcutaneous or Oral Oral or Intravenous Subcutaneous or Intravenous

subcutaneous or intravenous

A client is diagnosed with pernicious anemia. The nurse completes an assessment and finds severe pain on palpation at T12. The nurse would inform the health care provider because the nurse knows that which complication of pernicious anemia may be present? Vitamin B12 deficiency causing pernicious anemia, progressing for more than three months, can cause cancerous tumors of the skin. Vitamin B12 deficiency causing pernicious anemia, progressing for more than three months, can cause fatty tumors under the skin. Vitamin B12 deficiency causing pernicious anemia, progressing for more than three months, can cause degenerative disc disease. Vitamin B12 deficiency causing pernicious anemia, progressing for more than three months, can cause degenerative lesions of the spinal cord.

vitamin b12 deficiency causing pernicious anemia, progressing for more than three months, can cause degenerative lesions of the spinal cord.