prepU ch 49 Drugs Used to Treat Anemias
The nurse is teaching a nursing student about anemia and knows that it is important to start by explaining the causes of anemia. Which statement is true about the cause of anemia?
"Anemia is a condition caused by reduced amounts of hemoglobin, causing less oxygen to be delivered to the tissues."
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."
Which would be appropriate for a client who is receiving iron therapy?
Cautioning the client that stool may be dark or green
A client has been diagnosed with chronic renal failure. Which agent will assist in raising the client's hemoglobin levels?
Epoetin alfa
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?
Erythropoietin
A client has been diagnosed with anemia. The nurse knows that erythropoiesis-stimulating agent (ESA) drugs are used to treat anemia associated with certain conditions and treatments. What are expected adverse drug reactions caused by ESAs? (Select all that apply.)
Hypertension Headache Rashes Fatigue
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
Which would a nurse identify as the primary issue associated with anemias?
Ineffective red blood cells
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
Sickle cell anemia is an inherited disorder marked by the characteristic sickling of red blood cells. What are triggers of an episode of sickling? Select all that apply.
acute infections immune response inflammatory responses
A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition?
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
A patient comes to the clinic reporting fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse suspects that the patient will be diagnosed with:
iron deficiency anemia.
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
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 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."
A client prescribed epoetin alfa asks how the medication works. Which is the nurse's bestresponse?
"Increases the release of cells to increase the hemoglobin and hematocrit levels."
After teaching a patient who is receiving ferrous sulfate about the drug therapy regimen, which patient statement indicates that the teaching was successful?
"My stools might turn dark or green."
The nurse is preparing to administer an erythropoiesis-stimulating drug. The nurse checks the patient's chart, with the knowledge that the drug should not be administered to a patient with a target hemoglobin above which value?
12 g/dL
The average lifespan of a red blood cell (RBC) is approximately:
120 days.
The nurse is doing patient teaching with a 30-year-old gravida 1 who has sickle cell anemia. She is not currently in crisis. Providing education on which topic is the highest nursing priority?
Avoidance of infection
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
The mature red blood cell contains a nucleus. T or F
False
The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the health care provider to order for this client?
Iron supplement
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
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.
A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond?
This medication is destroyed in the stomach and can only be given by injection.
Cyanocobalamin is a vitamin B12 in a nasal formulation.
True
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
A client is receiving epoetin alfa. The nurse understands that this drug's duration of effect would be which amount of time?
24 hours
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
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
The nurse is teaching a nursing student about anemia and knows that it is important to include why anemia occurs. Which statement is true about why anemia occurs?
Anemia occurs due to chronic illnesses or specific deficiencies such as iron.
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.
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
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."
An adult client has developed renal failure secondary to an overdose of a nephrotoxic drug. Which assessment finding would the nurse recognize as being most suggestive of impaired erythropoiesis?
Fatigue and increased heart rate
The nurse is teaching a client about folinic acid rescue in chemotherapy. Which of the following information would the nurse include in the teaching plan?
Folinic acid rescue in chemotherapy includes leucovorin administration.
When describing the function of vitamin B12, what would be appropriate to include?
Maintenance of myelin sheath
There is a risk of antibody production with the use of epoetin. T or F
True
A male client is prescribed interferon. What is his probable diagnosis?
Viral hepatitis
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?
Vitamin B12
The physiology instructor is talking with the students about the development of blood cells. What would the instructor tell the students causes a hemocytoblast to change into an immature RBC?
Vitamin B12
After teaching a group of students about the types of anemia, the instructor determines that the teaching was successful when the students identify which anemia results from an inability to produce the intrinsic factor?
Pernicious anemia
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
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.
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
When administering iron injections, which method would the nurse use?
Z-track intramuscular