The Hematologic System ATI Pharmacology 4.0

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.Hypertension B. Muscle pain C. Edema D. Dry mouth

A Answer: Hypertension: Epoetin, an erythropoietic growth factor, can cause hypertension. The nurse should monitor the client's BP before and during therapy and inform the provider if it increases.

A nurse should assess a client who has megaloblastic anemia for indications of which of the following vitamin deficiencies? A. Vitamin B12 B. Vitamin C C. Calcium D. Vitamin E

A Vitamin B12: Clients who have megaloblastic anemia have a deficiency of vit b12, folic acid, or both. Cyanocobalamin (vit b12) treats moderate deficiencies. clients who have severe deficiency should take cyanocobalamin and folic acid.

A nurse is teaching a client about taking ferrous sulfate to treat iron-deficiency anemia. Which of the following instructions should the nurse include? A. Eat iron-enriched foods B. Spread the dosage across each day C. Take the drug on an empty stomach D. Increase dietary fiber E. report dark green/black stools

A,B,C,D Eat iron-enriched foods is correct. A client who has iron-deficiency anemia should increase iron intake by eating foods such as egg yolks, wheat germ, meat, and fish.Spread the dosage across each day is correct. Spreading out the iron intake throughout the client's waking hours allows the bone marrow to maximize the production of RBCs.Take the drug on an empty stomach is correct. Food reduces the absorption of ferrous sulfate. The client should take the drug on an empty stomach to increase drug absorption. If GI effects are troublesome, they can take the drug with food.Report dark green or black stools is incorrect. The nurse should tell the client to expect dark green or black stools. However, it is not necessary to report this adverse effect.Increase dietary fiber intake is correct. Ferrous sulfate can cause constipation. The client should increase fiber and fluid intake and exercise more often or more intensely.

A nurse is monitoring a client following ferrous sulfate administration. The nurse should the client for which of the following adverse effects? A. Phlebitis B. Dark, orange colored stools C. Constipation E. Injection site pain

C Answer: C Oral Iron supplementation is associated with constipation. The nurse should encourage the client to consume adequate amounts of fiber and fluids in their diet to minimize this effect.

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

C Answer: Enlarged spleen: With long-term use, filgrastim, a leukopoietic growth factor, can cause an enlarged spleen. The nurse should tell the client to monitor and report abdominal pain or fullness.

A nurse is caring for a client who is about to begin taking epoetin. An increase in which of the following laboratory values should indicate to the nurse that the therapy is effective? A. WBC B. Hgb C.PT D.INR

B Epoetin, an erythropoietic growth factor, increases the production of RBCs for clients who have anemia due to chronic renal failure for chemotherapy. Hgb and Hct Should increase with effective therapy.

A nurse is administering epoetin intravenously to a client who has renal failure. Which of the following actions should the nurse take? A. Save the next vial for the next dose B. Administer via IV bolus over 1 to 3 min C. Shake the vial before using D. dilute the drug first with D5w

B Answer: Administer via IV bolus over 1 to 3 min.: Instructions for administering the drug include administering it VIA IV bolus over 1 to 3 minutes.

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 mEq/L. Which of the following actions should the nurse take? A. Administer the drug with an analgesic B. Clarify the prescription with the provider C. Administer the required orally D. assess factor IX levels

B Answer: Clarify the prescription with the provider: Hyponatremia and fluid retention can occur with the administration of desmopressin, an antidiuretic hormone used in the treatment of hemophilia A. The client's sodium level is below the expected range of 136-145 mEq/L. The nurse should notify the provider of the client's current sodium level and clarify the prescription prior to administration.

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

B Answer: an antidiuretic hormone, can cause fluid retention and edema. The nurse should monitor fluid intake and output for clients receiving this drug.

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 laboratory values to determine therapeutic effectiveness? A. Creatinine clearance B. C- reactive protein C.Reticulocyte count D. Amylase level

C reticulocyte count measures the amount of immature RBCs. Folic acid, also called folate, is essential for erythropoiesis. clients who have a folic acid deficiency require a baseline reticulocyte count, as well as serum folate, Hgb, Hct, and RBC count and periodic monitoring during folic acid therapy to determine effectiveness.

A nurse is caring for a client who is taking ferrous sulfate to treat iron deficiency anemia and develops toxicity. Which of the following drugs should the nurse expect to use to treat this complication? A. Flumazenil B.Acetylcysteine C.Naloxone D.Deferoxamine

D Answer: Deferoxamine: Indications of iron toxicity include nausea, vomiting and diarrhea. Iron toxicity can lead to acidosis and shock. A chelating agent, such as deferoxamine, binds to the iron to reduce toxicity.

A nurse is caring for a client who is about to begin factor 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. Premedication with aspirin C. Administer it via rapid IV bolus D. Have emergency equipment ready

D Answer: Have emergency equipment ready: Factor VIII can cause a hypersensitive reaction and anaphylaxis. The nurse should monitor the client for hives, fever, wheezing, and difficulty breathing and have emergency equipment and drugs readily available.