Karchs chapter 49 MC
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."
A client is prescribed oral ferrous sulfate solution. Which statement by the client indicates that the client understands how to take the drug?
"I should drink the solution through a straw so my teeth don't get stained."
A patient has been receiving intramuscular injections of hydroxocobalamin as treatment for pernicious anemia. Which statement by the patient indicates that he understands the therapy?
"I will need these injections monthly for the rest of my life."
A client with a diagnosis of chronic renal failure will soon begin a regimen of epoetin that will be administered by the client at home. Which statement indicates that the nurse's initial health education has been successful?
"I'm not all that comfortable with giving myself an injection, but I'm sure I'll be able to learn."
A client diagnosed with iron deficiency anemia is learning about her prescribed iron supplement. Which additional information would the nurse include in the client's teaching plan?
"If constipation or diarrhea become severe, call your primary care provider."
Approximately what percentage of the body's red blood cells (RBCs) is destroyed and replaced each day?
1%
A patient receives ferrous sulfate. The nurse would expect this drug to begin acting within which time frame?
4 days
Which patient will be at the greatest risk for anemia and be the most likely candidate for epoetin alfa therapy?
A 62-year-old male with cancer
Which nursing diagnosis would provide the most plausible indication for the use of epoetin alfa in a client with renal failure?
Activity intolerance related to decreased oxygen-carrying capacity
After teaching a group of students about anemias, the instructor determines that the teaching was effective when the students identify what as the critical issue?
Altered red blood cell production or deficient functioning of red 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?
Cautioning the client that stool may be dark or green
A patient is to be administered an erythropoiesis-stimulating agent. Which of the following drugs would the nurse administer?
Epoetin alfa
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 mature red blood cell contains a nucleus.
False
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 monitor for which adverse effect?
Flulike symptoms
What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?
Impaired tissue oxygenation related to anemia
A nurse administers erythropoietin. What assessment finding is attributable to the increased effect of this hormone? Select all that apply.
Increased red blood cell count, Increased hemoglobin
Which would a nurse identify as the primary issue associated with anemias?
Ineffective red blood cells
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.
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:
Iron levels
When describing the function of vitamin B12, what would be appropriate to include?
Maintenance of myelin sheath
Adverse effects of epoetin and darbepoetin include increased risks of what condition?
Myocardial infarction
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?
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
For what purpose would the nurse administer postoperative epoetin alfa to the client who is a Jehovah's Witness?
Reduce the need for allogenic blood transfusion
The nurse is caring for a patient with chronic kidney disease who is receiving epoetin alfa. Which assessment finding would be of greatest concern for the nurse?
Reports of calf pain on dorsiflexion of the foot
After reviewing the major types of anemia, students demonstrate understanding of the information when they identify what as an example of a hemolytic anemia?
Sickle cell anemia
All hematopoietic and immune blood cells are derived from which cells in the bone marrow?
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?
Subcutaneous or Intravenous
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.
Which patient will the nurse assess first?
The patient with a decreased WBC count
A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective?
The patient's hemoglobin level is 11 g/dL
Mr. Lepp is a 63-year-old man who was diagnosed with colon cancer several weeks ago and who is scheduled to begin chemotherapy. He reports to the nurse that he read about the need for erythropoietin in an online forum for cancer patients and wants to explore the use of epoetin alfa with his oncologist. Which fact should underlie the nurse's response to Mr. Lepp?
The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.
There is a risk of antibody production with the use of epoetin.
True
The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician's attention prior to administering the medication?
Uncontrolled hypertension
A male client is prescribed interferon. What is his probable diagnosis?
Viral hepatitis
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:
anemia
An older adult client diagnosed with chronic renal failure has begun experiencing increasing fatigue. The nurse would anticipate educating the client on what likely medication prescription?
epoetin alfa
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Which laboratory value(s) will the nurse assess that indicates erythropoietin has been secreted from the client's kidneys? Select all that apply.
hemoglobin, red blood cells
A client with chronic renal failure has been prescribed epoetin alfa. The nurse should confirm with the health care provider whether the client requires:
iron
A client with chronic kidney disease has been receiving epoetin alfa subcutaneous injections and has a hemoglobin level of 9.9 g/dl (99 g/L). Which treatment would the nurse anticipate being prescribed when the client reports new-onset fatigue?
iron supplements
A client, currently prescribed epoetin alfa, has recent blood work that reveals a hemoglobin level of 12.8 g/dL. What action does this assessment finding necessitate regarding the epoetin alfa?
temporarily withholding administration
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.
A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client's condition closely. When taking the client's vital signs, the nurse should pay particular attention to what assessment datum?
blood pressure
While reviewing a client's the record, the nurse sees that the client received a dose of interferon alpha-2b? For what disorder does the nurse suspect the client was being treated?
chronic hepatitis C
