Pharm 2 Chapter 49: Drugs Used to Treat Anemias 5-8
"Oral forms of vitamin B12 will not be absorbed."
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." "With severe deficiencies like yours, oral vitamin B12 is not effective." "Oral ingestion of vitamin B12 causes irritation and bleeding." "Pernicious anemia causes changes in the mucous membrane lining and impairs absorption."
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 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? Iron deficiency 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. 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.
HCT
A client comes to the clinic for epoetin alfa therapy. The nurse monitoring the client knows that blood will be drawn before the treatment begins, in order to evaluate which level? HCT Blood glucose Na+ WBC
anemia.
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. anemia. thrombocytopenia.
Intramuscular
A client is receiving hydroxocobalamin for treatment of pernicious anemia. The nurse would administer this agent by which route? Intramuscular Oral Intravenous Subcutaneous
Allergic reaction
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? Nausea Allergic reaction Dark stools Vomiting
Interferon alfa
A male client is diagnosed with multiple myeloma. What treatment regimen would the nurse expect the health care provider to order? Sargramostim Filgrastim Interferon alfa Epoetin
Increased red blood cell count Increased hemoglobin
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 Anemia Increased urinary output Decreased oxygenation in the bloodstream Increased hemoglobin
The patient's hemoglobin level is 11 g/dL
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 white blood cell level is within reference ranges The patient's hemoglobin level is 11 g/dL The patient maintains an oxygen saturation of 92% on room air Capillary refill in the patient's nail beds is less than or equal to 3 seconds
Oral
After teaching a group of students about therapy for iron toxicity, the instructor determines that the students need additional teaching when they identify that the antidote can be administered by which route? Oral Subcutaneous Intramuscular Intravenous
Stem cells
All hematopoietic and immune blood cells are derived from which cells in the bone marrow? Stem cells Alfa cells Beta cells Theta cells
Fatigue and increased heart rate
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 Frequent infections and low neutrophil levels Increased blood pressure and peripheral edema Agitation and changes in cognition
1%
Approximately what percentage of the body's red blood cells (RBCs) is destroyed and replaced each day? 4% 2% 3% 1%
A client with a hemoglobin of 12, with shortness of breath.
For which client would epoetin alfa NOT be indicated? A client with a hemoglobin of 10, who is asymptomatic. A client with a hemoglobin of 8, who is asymptomatic. A client with a hemoglobin of 11, with shortness of breath. A client with a hemoglobin of 12, with shortness of breath.
hemoglobin
Red blood cells (RBCs) are mainly composed of _________________, which enables the cells to carry oxygen to the cells in the body. platelets hemoglobin hematocrit white blood cells potassium
False
The mature red blood cell contains a nucleus. True False
Increased red blood cell count
The nurse administers epoetin alfa (Epogen). What is the therapeutic response the nurse expects to assess? Elevated white blood cell count Increased red blood cell count Increased resistance to infection Elevated heart rate
Avoidance of infection
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? Constipation prevention Iron-rich foods Avoidance of infection Control of pain
Folinic acid rescue in chemotherapy includes leucovorin administration.
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 levothyroxine administration. Folinic acid rescue in chemotherapy includes Lipitor administration. Folinic acid rescue in chemotherapy includes Levophed administration. Folinic acid rescue in chemotherapy includes leucovorin administration.
3 times a week
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? Once a week Twice a week 4 times a week 3 times a week
11-month-old female with HIV acquired from her mother
The nurse would contact the prescriber immediately if interferon was prescribed for which client? 34-year-old male with chronic hepatitis B 48-year-old female with hepatitis C 72-year-old male with AIDS-related Kaposi's sarcoma 11-month-old female with HIV acquired from her mother
Anemia related to zidovudine therapy in HIV-associated illness Anemia related to chemotherapy in patients with cancer Anemia from chronic renal disease (CRD)
The prototype drug used to create red blood cells (RBCs) is epoetin alfa (Epogen, Procrit). It has many indications for use. Which are selected indications? Select all that apply. Anemia related to zidovudine therapy in HIV-associated illness Thrombocytopenia from chemotherapy Neutropenia due to chemotherapy Anemia related to chemotherapy in patients with cancer Anemia from chronic renal disease (CRD)
A client whose acute myelogenous leukemia necessitated a bone marrow transplant
Which client would likely be the most appropriate candidate for treatment with filgrastim? A client who has undergone a mastectomy for the treatment of breast cancer A client whose acute myelogenous leukemia necessitated a bone marrow transplant A client who developed acute renal failure secondary to rhabdomyolysis A client with acquired immune deficiency syndrome (AIDS) who has been diagnosed with Kaposi's sarcoma
The patient who has a blood pressure of 240/120 mm Hg
Which patient should not receive epoetin alfa (Epogen) as ordered at 9 am? The patient who is "too tired to get out of bed" The patient who has missed a round of chemotherapy The patient with a heart rate of 100 beats per minute The patient who has a blood pressure of 240/120 mm Hg
"I should drink the solution through a straw so my teeth don't get stained."
A client is prescribed oral ferrous sulfate solution. Which statement by the client indicates that the client understands how to take the drug? "I'll mix the dose with orange juice to make it easier to swallow." "I should drink a big glass of water after swallowing the solution." "I can mix the dose with a small amount of yogurt to make it taste better." "I should drink the solution through a straw so my teeth don't get stained."
"Increases the release of cells to increase the hemoglobin and hematocrit levels."
A client prescribed epoetin alfa asks how the medication works. Which is the nurse's best response? "Increases the release of cells to increase the hemoglobin and hematocrit levels." "Decreases release of reticulocytes, which inhibits red blood cell (RBC) production." "Stimulates the growth and development of white blood cells (WBC) to prevent neutropenia." "Releases erythropoiesis from the kidneys to increase the number of platelets."
This medication is destroyed in the stomach and can only be given by injection.
A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond? The oral route is not as effective. The drug dose must be increased if being given via the oral route. This medication is destroyed in the stomach and can only be given by injection. This medication causes severe diarrhea if given orally.
Gastrointestinal (GI) tract Bone marrow Cancerous tissues
Deficiencies in folic acid are noticed first in rapidly growing cells, such as those in which areas? (Select all that apply.) Respiratory tract Gastrointestinal (GI) tract Bone marrow Cancerous tissues Cardiac system
The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.
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? Epoetin alfa is normally contraindicated in patients who are receiving radiotherapy or chemotherapy. Mr. Lepp's oncologist should have begun treatment with epoetin alfa immediately after he was diagnosed. Treatment with epoetin alfa will likely begin 4 to 6 days before Mr. Lepp's first round of chemotherapy and continue indefinitely. The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.
