Chapter 56: Hematopoietic Agents

The nurse is administering epoetin alfa [Procrit] to a patient receiving chemotherapy. Which adverse effect is a potential risk with this drug?

A. Accelerated tumor progression

The nurse should review which baseline data before starting epoetin alfa [Epogen] therapy in a patient with chronic renal failure (CRF)? (Select all that apply.)

A. Ferritin level D. Blood pressure trends E. Hemoglobin and hematocrit

The nurse is evaluating the effectiveness of the drug oprelvekin [Neumega] in a patient undergoing cancer chemotherapy. Which finding is most indicative that this drug is having its intended effect?

A. Platelet count of 150 × 103/mm3

The nurse is explaining the use of romiplostim [Nplate] to treat idiopathic thrombocytopenic purpura (ITP). Which patient statement indicates understanding of the nurse's explanation?

B. "I'll let my healthcare provider know if I have any pain in my joints."

A maintenance dose of epoetin alfa [Epogen] is ordered for a dialysis patient. What is an appropriate dosage for administration?

B. 75 units/kg IV 3 times/wk

The healthcare provider prescribes hematopoietic growth factor for a patient. The nurse should notify the healthcare provider to question the prescription for which patient condition?

B. A patient with uncontrolled hypertension

The nurse is caring for a patient undergoing cancer chemotherapy who presents with rash, bone pain, hypertension, and pedal edema. Which symptom is most likely an adverse reaction to the filgrastim [Neupogen] the patient is receiving?

B. Bone pain

Which finding indicates a positive outcome from treatment with filgrastim [Neupogen]?

B. The neutrophil count increases.

patient with nonmyeloid cancer is receiving oprelvekin [Neumega]. Which adverse effects are most likely associated with this drug? (Select all that apply.)

C. Fluid retention D. Atrial fibrillation E. Anaphylactic reactions

The nurse is caring for a patient with anemia related to chronic renal failure. Which agent might be used to treat the anemia?

D. Epoetin alfa [Procrit]

Which patients are eligible to receive erythropoiesis stimulating agents? (Select all that apply.)

a. All patients with nonmyeloid malignancies who require transfusions b. All patients with nonmyeloid malignancies whose chemotherapy is palliative d. All patients with nonmyeloid malignancies and chemotherapy-induced anemia

A prescriber has ordered filgrastim (granulocyte colony-stimulating factor) for a patient undergoing myelosuppressive chemotherapy. The nurse will prepare the patient for which potential side effect?

a. Bone pain

A patient is about to undergo a procedure to harvest hematopoietic stem cells from the bone marrow. Which medication will the nurse anticipate giving before this procedure?

a. Filgrastim (Neupogen)

A patient with lung cancer receives filgrastim (Neupogen) after chemotherapy to reduce neutropenia. The patient reports a moderate degree of bone pain. What will the nurse do?

a. Obtain an order to administer acetaminophen.

A patient with a hemoglobin of 7.2 gm/dL begins therapy with an ESA. Two weeks later the patient's hemoglobin is 8.3 gm/dL. The nurse anticipates that the provider will:

a. reduce the ESA dose.

A nurse is teaching a patient with chronic renal failure who will begin receiving epoetin alfa (Epogen) about this drug therapy. Which statement by the patient indicates understanding of the teaching?

b. "Taking this drug should eliminate my need for blood transfusions."

A patient with CRF who will begin receiving an erythropoiesis stimulating agent (ESA) is admitted to the hospital. The nurse notes that the patient's heart rate is 82 beats per minute, and the blood pressure is 140/100 mm Hg. A complete blood count reveals a hemoglobin of 8 gm/dL and a hematocrit of 29%. What will the nurse do?

b. Withhold the ESA and request an order for an antihypertensive medication.

A nursing student asks a nurse why patients with chronic renal failure (CRF) have low erythrocyte counts. Which response by the nurse is correct?

c. "Erythropoietin is no longer produced by cells in the kidneys."

The nurse is caring for a patient who begins to complain of shortness of breath. The nurse assesses the patient and notes 3+ pitting edema bilaterally in the lower extremities. Which medication taken by the patient causes the most concern?

c. Oprelvekin (interleukin-11)

A patient with chronic renal failure who is on dialysis receives an ESA. The nurse caring for this patient during dialysis notes that the patient's hemoglobin is 11.3 gm/dL, up from the 10.4 gm/dL recorded 2 weeks ago. The patient's blood pressure is 120/80 mm Hg. The nurse will contact the provider to suggest:

c. giving heparin.