Karch - Ch49: Drugs Used to Treat Anemias

A 50-year-old female patient who has pernicious anemia asks you why vitamin B12 must be administered parenterally. What is the best response to her question? "Oral forms of vitamin B12 will not be absorbed." "Oral ingestion of vitamin B12 causes irritation and bleeding." "With severe deficiencies like yours, oral vitamin B12 is not effective." "Pernicious anemia causes changes in the mucous membrane lining and impairs absorption."

"Oral forms of vitamin B12 will not be absorbed."

A client is receiving epoetin alfa. The nurse understands that this drug's duration of effect would be which amount of time? 36 hours 48 hours 24 hours 12 hours

24 hours

The nurse is teaching a male patient receiving epoetin alfa about the drug. The nurse informs the patient that he will receive the drug at which frequency? 4 times a week 3 times a week Once a week Twice a week

3 times a week

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 who has undergone a mastectomy for the treatment of breast cancer A client with acquired immune deficiency syndrome (AIDS) who has been diagnosed with Kaposi's sarcoma A client whose acute myelogenous leukemia necessitated a bone marrow transplant

A client whose acute myelogenous leukemia necessitated a bone marrow transplant

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? A protein supplement A folic acid supplement A blood transfusion An iron supplement

An iron supplement

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? Respirations Temperature Blood pressure Pulse

Blood pressure

The client is a woman, 69 years of age, seen in the clinic for anemia and administration of epoetin alfa. Before giving the drug, the nurse takes a complete history and reviews the client's EMR, because the nurse knows that epoetin alfa is contraindicated for which conditions? (Select all that apply.) Clients with a hypersensitivity to human albumin Clients with exposure to anthrax Clients with a recent infection Clients needing an emergency transfusion Clients with uncontrolled hypertension

Clients with a hypersensitivity to human albumin, Clients needing an emergency transfusion, Clients with uncontrolled hypertension

The nurse notes a decreased red blood cell (RBC) count, decreased hemoglobin and hematocrit, as well as a decreased mean corpuscular volume. This could be attributable to a decrease in secretion of what hormone? Interferon Erythropoietin Colony-stimulating factor Interleukins

Erythropoietin

A 69-year-old client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect? Flulike symptoms Cyanosis and pallor Profound diaphoresis Decreased level of consciousness

Flulike symptoms

A client 19 years of age who is a drug addict comes to the emergency department reporting extreme fatigue and shortness of breath. The nurse assesses the client and, after taking a complete history, determines that the client has malnutrition. The nurse knows that malnutrition can cause which type of anemia? Folic acid deficiency anemia occurs because of a dietary lack of folic acid, a component necessary in the formation of red blood cells. Pernicious anemia occurs because of a dietary lack of folic acid, a component necessary in the formation of red blood cells. Anemia in chronic kidney disease occurs because of a dietary lack of folic acid, a component necessary in the formation of red blood cells. Iron deficiency anemia occurs because of a dietary lack of folic acid, a component necessary in the formation of red blood cells.

Folic acid deficiency anemia occurs because of a dietary lack of folic acid, a component necessary in the formation of red blood cells.

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

Intramuscular

A nurse has been assigned to a 43-year-old man who is to receive epoetin alfa therapy. The patient is HIV-positive and has anemia related to zidovudine therapy. The nurse will monitor: Swelling of veins Renal failure Chemotherapy Iron levels

Iron levels

When assessing a patient with anemia, the nurse notes that the patient has developed peripheral numbness and poor coordination. The patient's family states that the patient appears to be confused at times at home. Neurologic symptoms most often accompany which type of anemia? Thalassemia major Pernicious anemia Iron deficiency anemia Folic acid deficiency

Pernicious anemia

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 Produce rennin Produce angiotensin Inactivate vitamin D

Produce erythropoietin

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

Sickle-cell anemia

All hematopoietic and immune blood cells are derived from which cells in the bone marrow? Stem cells Theta cells Beta cells Alfa cells

Stem cells

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 nursing instructor is teaching students about the myelin sheath of the central nervous system (CNS). The nurse knows that teaching has been effective when a student identifies which vitamin as necessary for the formation of the myelin sheath in the CNS? Folic acid Vitamin B12 Vitamin C Vitamin D

Vitamin B12

A nursing instructor is teaching students about the myelin sheath of the central nervous system (CNS). The nurse knows that teaching has been effective when a student identifies which vitamin as necessary for the formation of the myelin sheath in the CNS? Folic acid Vitamin D Vitamin C Vitamin B12

Vitamin B12

A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with: hypoglycemia. hypertension. thrombocytopenia. anemia.

anemia.

A female client diagnosed with vitamin B12 deficiency asks the nurse why she needs to take the vitamin. Which statement would the nurse use when teaching the client about vitamin B12? "Vitamin B12 is essential to growth, cell reproduction, the manufacture of myelin, vitreous humor, and blood cells." "Vitamin B12 is essential to growth, cell reproduction, and the manufacture of myelin, and blood cells." "Vitamin B12 is essential to growth, cell reproduction, the manufacture of myelin, the repair of broken bones, and blood cells." "Vitamin B12 is essential to growth, cell reproduction, and the manufacture of myelin."

"Vitamin B12 is essential to growth, cell reproduction, and the manufacture of myelin, and blood cells."

A client is experiencing iron toxicity. Which agent would the nurse expect to be given? Succimer Edetate calcium disodium Deferoxamine Dimercaprol

Deferoxamine

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 degenerative lesions of the spinal cord. 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 degenerative disc disease. 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 lesions of the spinal cord.