PrepU - Chapter 9: Drug Therapy for Hematopoietic Disorders and to Enhance Immunity
The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. What is the cause of anemia?
"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."
The patient with chronic renal failure requires an agent to increase red blood cell production. What drug does the nurse anticipate administering?
Epoetin alfa
The anemia that occurs with chronic renal failure is caused by the kidneys themselves. What inability of the kidneys causes anemia in chronic renal failure?
Produce erythropoietin
A male client is diagnosed with severe neutropenia. The physician prescribes filgrastim. What is the desired effect?
To increase white blood cells
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
Which would be appropriate for a client who is receiving iron therapy? -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 -Advising the client to limit the amount of fiber in his diet
Cautioning the client that stool may be dark or green
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. What is the effect of Epogen?
Chronic kidney disease slows the production of red blood cells causing anemia. Epogen stimulates the production of red blood cells to treat anemia.
A client is experiencing iron toxicity. Which agent would the nurse expect to be given?
Deferoxamine p 628, 634
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 acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia. -Iron supplements prevent depletion of hemoglobin cells from anxiety to treat anemia. -Iron supplements prevent infection so hemoglobin cells grow back faster to treat anemia. -Iron supplements prevent bleeding to replenish hemoglobin cells faster to treat anemia.
Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia.
Adverse effects of epoetin and darbepoetin include increased risks of what condition?
Myocardial infarction
All hematopoietic and immune blood cells are derived from which cells in the bone marrow?
Stem cells
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
The nurse is teaching a client about iron deficiency anemia. The nurse would include in the teaching plan that iron deficiency anemia results from:
a lack of iron in the body.
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 is prescribed oral ferrous sulfate solution. Which statement by the client indicates that the client understands how to take the drug? -"I'll mix the dose with orange juice to make it easier to swallow." -"I should drink a big glass of water after swallowing the solution." -"I can mix the dose with a small amount of yogurt to make it taste better." -"I should drink the solution through a straw so my teeth don't get stained."
"I should drink the solution through a straw so my teeth don't get stained."
The nurse is caring for a client with a WBC of 700 cells/mm3. Which discharge instruction is most important for the nurse to share with this client?
"Stay out of crowded places such as grocery stores."
The nurse is mentoring a first-year nursing student while caring for a client with a disease that affects the hematopoietic system. The student looks confused and says "I've never heard of that system. What is it?" How would the nurse repond?
"The hematopoietic system is composed of fluid, red blood cells, white blood cells, and platelets."
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 home care nurse is caring for a client who is self-administering epoetin. What assessment is most important for the nurse to complete during the visit?
Blood pressure
A nurse is monitoring a patient who has received an "interferon." What therapeutic effect will the nurse expect to find when assessing this patient?
Decrease in viral load
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
The nurse is caring for Ms. Johnson, a 62-year-old woman with a history of diabetes mellitus and diabetic nephropathy. The physician orders sargramostim as part of her treatment. What laboratory result would be anticipated secondary to the administration of this medication?
Elevation of serum creatinine level
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
What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?
Impaired tissue oxygenation related to anemia
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?
Increased RBC count
The nurse administers epoetin alfa (Epogen). What is the therapeutic response the nurse expects to assess?
Increased red blood cell count
The nurse is administering epoetin alfa (Epogen). Which administration technique would not be considered appropriate for the patient identified? -The nurse administers epoetin alfa (Epogen) as a bolus injection as the patient completes dialysis. -The nurse administers epoetin alfa (Epogen) into the patient's central IV line. -The nurse administers the epoetin alfa (Epogen) into the patient's peripheral IV line. -The nurse administers epoetin alfa (Epogen) via IM injection.
The nurse administers epoetin alfa (Epogen) via IM injection.
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." -"I need to make sure that I eat enough foods containing iron." -"It might take several months before my iron levels get back to normal." -"I need to avoid taking the drug with coffee or tea."
"I need to take an antacid with the pill to prevent an upset stomach."
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.
Katie, a 45-year-old patient with breast cancer, is currently undergoing chemotherapy. She is started on epoetin alfa secondary to decreased hemoglobin and hematocrit levels. What rule is important when administering epoetin alfa, after reconstituting it?
Do not shake the drug vigorously.
Your client has been diagnosed with genital warts. Which of the following medications would you anticipate being ordered?
Interferon alfa-2b
Your client has been diagnosed with genital warts. Which of the following medications would you anticipate being ordered? Lorazepam Procrit Monistat Interferon alfa-2b
Interferon alfa-2b
A male client is self-administering epoetin in the home. The nurse encourages him to include what supplements as part of his daily medication regimen?
Iron
Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy? -A 20-year-old female -A 30-year-old pregnant woman -A 62-year-old male with cancer -A 40-year-old male with a high white blood cell count
A 62-year-old male with cancer
The nurse is working with a male client diagnosed with chronic renal disease. To increase compliance with the drug regimen, what should the nurse provide the patient who has been prescribed epoetin alfa?
A calendar to mark the days of the week the drug is to be administered
For which client would Procrit NOT be indicated? -A client with a hemoglobin of 8, who is asymptomatic. -A client with a hemoglobin of 11, with shortness of breath. -A client with a hemoglobin of 12, with shortness of breath. -A client with a hemoglobin of 10, who is asymptomatic.
A client with a hemoglobin of 12, with shortness of breath. ch9, p 152
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.
Which would a nurse identify as the primary issue associated with anemias?
Ineffective red blood cells
A male client is diagnosed with multiple myeloma. What treatment regimen would the nurse expect the physician to order?
Interferon alfa
Prior to administration of an iron preparation, what should a nurse assess?
Hematocrit and hemoglobin
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
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.
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
The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the physician to order for this client?
Iron supplement