Prep U for Abrams's Clinical Drug Therapy, 10th Edition Chapter 9: Drug Therapy for Hematopoietic Disorders and to Enhance Immunity
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. pg. 150
The clinic nurse receives a call from a male client who has been taking interferon alfa for 7 days. The client states that he has become very sad and wonders if life is worth living. What is the best response by the nurse to this client?
"Come to the clinic as soon as possible." pg.
A 22-year-old client with no significant health history reports severe fatigue. The client is found to be anemic as a result of vitamin B12 deficiency. What assessment question by the nurse best addresses a potential etiology?
"Do you eat meat or animal products?"
Mr. Singh is a 66-year-old man who is receiving chemotherapy for the treatment of lung cancer that has metastasized to his liver. In an effort to prevent infection, Mr. Singh has been prescribed filgrastim (Neupogen). Which of the nurse's following assessment questions most directly addresses a common adverse effect of filgrastim?
"Do you feel like you're having any pain in your bones?" pg. 155
The nurse is caring for a client with a WBC of 700 cells/mm3. Which discharge instruction is most important for the nurse to share with this client?
"Stay out of crowded places such as grocery stores." pg. 154
You are precepting a nursing student and together you are caring for a patient who is to receive interleukins. The student nurse asks you what happens physiologically when a patient receives interleukins. What would be your best response?
"The patient has increases in the number of natural killer cells." pg. 159
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, and the manufacture of myelin, and blood cells." pg. 613
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 pg. 151
The pharmacology instructor is talking about interferon. The instructor explains that agents such as interferons have more than one biologic function. What function is NOT associated with interferons?
Antibacterial pg. 157
The nurse is caring for a client who had a post-partum hemorrhage two weeks ago that resulted in anemia. The client has called the clinic after passing dark stools, stating, "I looked this up online, and I'm worried I might have stomach or intestinal bleeding." What is the nurse's best initial action?
Ask the client whether she is taking iron supplements
A patient has and elevated white blood cell (WBC) count. What is the nurse's primary action related to this finding?
Assess the patient for other signs of infection. pg. 150
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 pg. 152
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 pg. 152
Which would be appropriate for a client who is receiving iron therapy?
Cautioning the client that stool may be dark or green pg. 631
A nurse is to use a single-dose 1 mL vial to administer 0.5 mL of epoetin alfa to a 39-year-old woman who is being treated for chemotherapy-induced anemia. Which of the following will the nurse do with the unused portion of the drug?
Discard the unused portion of the drug. pg. 152
Katie, a 45-year-old patient with breast cancer, is currently undergoing chemotherapy. She is started on epoetin alfa secondary to decreased hemoglobin and hematocrit levels. What rule is important when administering epoetin alfa, after reconstituting it?
Do not shake the drug vigorously. pg. 152
The nursing instructor is talking with a student about erythropoietin drug therapy. What is an adverse effect of erythropoietin drug therapy that the instructor would tell the student about?
Edema pg. 152
What assessment finding does the nurse determine is a therapeutic outcome of administering filgrastim (Neupogen) to the patient?
Elevation of white blood cell count (WBC) pg. 151
Your client has been diagnosed with genital warts. Which of the following medications would you anticipate being ordered?
Interferon alfa-2b pg.
The nurse has just admitted a client to the unit who is newly diagnosed with Kaposi's sarcoma. The health care provider has order an IV infusion of an interferon. What drug has the provider ordered?
Interferon alfa-2b pg. 157
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 pg. 153
The nurse is caring for a female client in the home. The client is prescribed filgrastim. What would be included in the nurse's education plan?
Techniques to reduce exposure to infection pg.
The nurse is caring for a patient newly diagnosed with anemia. Which intervention is appropriate?
Telemetry monitoring pg. 150
The nurse administers interferon alpha-2b to a patient. Which assessment finding will the nurse act on immediately?
The patient has elevated liver function tests. pg. 148
Which patient should not receive epoetin alfa (Epogen) as ordered at 9 am?
The patient who has a blood pressure of 240/120 mm Hg pg. 152
When planning care for a patient who is receiving filgrastim (Neupogen) for a nonmyeloid malignancy, the nurse should formulate which of the following patient outcomes? (Select all that apply.)
The patient will not develop an infection. The patient will not experience bone pain. The patient will be able to self-administer filgrastim at home. The patient will not develop febrile neutropenia. pp. 155-156.
A male client is diagnosed with severe neutropenia and is prescribed filgrastim. What is the desired effect?
To increase white blood cells pg. 153
A 69-year-old female 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?
flu-like symptoms pg.
The prototype drug used to create red blood cells (RBCs) is epoetin alfa (Epogen, Procrit). The pharmacokinetics include which of the following? Choose all that apply.
intravenous subcutaneous pg. 151
A male client is self-administering epoetin in the home. The nurse encourages him to include what supplements as part of his daily medication regimen?
iron pg. 153
A client's medication history reveals having been previously treated with aldesleukin. The nurse should know that this client likely has a history of what form of cancer? Select all that apply.
metastatic kidney cancer metastatic melanoma skin cancer
A 67-year-old man who is being treated for prostate cancer is taking epoetin alfa. The nurse will instruct the patient to:
schedule an appointment to measure hemoglobin twice a week for at least 2 to 6 weeks. pg. 152
Which of the following patients is most likely to benefit from the administration of epoetin alfa?
A 66-year-old woman with type 1 diabetes who is experiencing the effects of diabetic nephropathy pg. 151
A client, 33 years of age, is seen in the clinic for iron deficiency anemia. The client is prescribed oral iron supplements. Before the client is sent home, the nurse provides discharge instructions for the client to sign. Which generalized system reactions would the nurse include in the instructions?
Allergic reaction pg. 152
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 pg. 153
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 pg.
The patient with chronic renal failure requires an agent to increase red blood cell production. What drug does the nurse anticipate administering?
Epoetin alfa pg. 151
A patient has been prescribed epoetin alfa. In reviewing this patient's history, what would the nurse know contraindicates the use of epoetin alfa?
HTN pg. 152
Ms. Ziem is prescribed filgrastim. The nurse provides education to Ms. Ziem about this therapy. Which statement would indicate the patient understood the teaching?
I will avoid crowds and people with illnesses." pg. 155
What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?
Impaired tissue oxygenation related to anemia pg. 151
The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?
Increased RBC count pg. 151
When the patient is taking filgrastim, what positive outcome does the nurse anticipate observing from the laboratory studies?
Increased neutrophil count pg. 156
The nurse administers epoetin alfa (Epogen). What is the therapeutic response the nurse expects to assess?
Increased red blood cell count pg. 151
A male client is prescribed interferon. What is his probable diagnosis?
Viral hepatitis pg.
Which would a nurse identify as the primary issue associated with anemias?
Ineffective red blood cells pg.
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 pg. 153
patient has just been told that her cancer has metastasized to the right kidney. An interferon has been prescribed to treat this metastasis. The patient asks why the interferon is ordered. What is the nurse's best response?
It has been shown to inhibit tumor growth. pg.
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
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." pg. 631
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 pg.150