Pharm: Hematopoisis
The clinic nurse receives a call from a client who has been taking interferon alfa for 7 days. The client states that he has become very sad and wonders if life is worth living. What is the best response by the nurse to this client?
"Come to the clinic as soon as possible."
A patient with chronic renal failure receiving epoetin alfa will be having a total left hip arthroplasty. What supplementation should the patient receive prior to surgery?
An iron supplement
Prior to administration of an iron preparation what should a nurse assess?
Hematocrit and hemoglobin
Your client is taking Procrit. He requests changing his medication from the IM to the PO route. Your best response is:
This medication is destroyed in the stomach and can only be given IM.
A male client is prescribed interferon. What is his probable diagnosis?
Viral hepatitis
To evaluate immune function, the nurse should look most closely at which laboratory value?
White blood cells
A patient has just received IV cytotoxic chemotherapy. Which patient statement indicates a need for further teaching about this therapy with filgrastim (Neupogen)?
"I am going to administer my filgrastim (Neupogen) as soon as I get home today."
A nurse has taught a patient about filgrastim (Neupogen) and epoetin alfa (Epogen) administration. Which patient statement indicates teaching was effective?
"I should tell my healthcare provider if I feel depressed."
You are precepting a nursing student and together you are caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What would be your best response?
"The patient has increases in the number of natural killer cells."
The pharmacology instructor is talking about interferon. The instructor explains that agents such as interferons have more than one biologic function. What are the functions of interferons?
-prevent virus particles from replicating inside cells -stimulate interferon receptor sites on noninvaded cells to produce antiviral proteins, which prevent viruses from entering the cell -inhibit tumour growth and replication, to stimulate cytotoxic T-cell activity, and to enhance the inflammatory response
Which of the following patients will be at the greatest risk for anemia and would be the most likely candidate for epoetin alfa therapy?
A 62-year-old male with cancer
A patient has and elevated white blood cell (WBC) count. What is the nurse's primary action related to this finding?
Assess the patient for other signs of infection.
Which of the following would be appropriate for a client who is receiving iron therapy?
Cautioning the client that stool may be dark or green
In learning about immunostimulants, what would you learn is an expected outcome of these medications?
Decreased numbers or severity of infections
A nurse is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug?
Discard the unused portion of the drug.
The nursing instructor is talking with a student about erythropoietin drug therapy. What is an adverse effect of erythropoietin drug therapy that the instructor would tell the student about?
Edema
To prevent febrile neutropenia in the older adult taking chemotherapy, what does the nurse anticipate administering prophylactically?
Filgrastim
Interferon alfa-2b indications:
Hairy cell leukemia malignant melanoma AIDS-related Kaposi's sarcoma chronic hepatitis B and C intralesional treatment of condylomata acuminata in patients 18 years of age or older
The nurse is caring for a client who has been receiving filgrastim. The nurse expects to perform which action concerning this drug on the day prior to the client's chemotherapy treatment?
Hold the medication
A patient has been prescribed epoetin alfa. In reviewing this patient's history what would the nurse know contraindicates the use of epoetin alfa?
Hypertension
The nurse administers epoetin alfa (Epogen). What is the therapeutic response the nurse expects to assess?
Increased red blood cell count
Which of the following would a nurse identify as the primary issue associated with anemias?
Ineffective red blood cells
You have just admitted a patient to your unit that was newly diagnosed with Kaposi's sarcoma. The physician has order an IV infusion of an interferon. What drug has the physician ordered?
Interferon alfa-2b
You are caring for a client who is receiving epoetin alfa. What adjunct treatment will you expect the physician to order for this client?
Iron supplement
A patient has just been told that her cancer has metastasized to the right kidney. An interferon has been prescribed to treat this metastasis. The patient asks why the interferon is ordered. What is the nurse's best response?
It has been shown to inhibit tumor growth.
Adverse effects of epoetin and darbepoetin include increased risks of what condition?
Myocardial infarction
A nurse is caring for a 73-year-old male client scheduled to undergo chemotherapy. What drug would the nurse expect to be ordered to prevent infection in this client?
Pegfilgastim (Neulasta)
The anemia that occurs with chronic renal failure is caused by the kidneys themselves. What inability of the kidney disease causes anemia in chronic renal failure?
Produce erythropoietin
The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which of the following assessment findings would be of greatest concern for the nurse?
Reports of calf pain on dorsiflexion of the foot
The nurse is caring for a female client in the home. The client is prescribed filgrastim. What would be included in the nurse's education plan?
Techniques to reduce exposure to infection
Which symptom, if assessed after the administration of epoetin alfa (Epogen), would be cause for alarm?
The patient displays weakness on one side of the body.
What are some potential adverse effects of an erythropoietin?
edema diarrhea hypertension
Your client has been diagnosed with genital warts. Which of the following medications would you anticipate being ordered?
Interferon alfa-2b
A client is prescribed iron therapy using iron dextran. The nurse would administer this drug by which route?
Intramuscular
Which patient should not receive epoetin alfa (Epogen) as ordered at 9 am?
The patient who has a blood pressure of 240/120 mm Hg
