Prep U Chapter 11
A client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. When the nurse is assessing for therapeutic effects, what question is most warranted?
"How is your energy level compared with a few days ago?"
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."
The nurse is caring for a client who has been newly diagnosed with cancer. The client tells the nurse, "I saw advertisements on epoetin alfa and I want to start taking it immediately so I don't get tired from chemotherapy." What is the nurse's best response?
"Epoetin alfa is only effective if you develop anemia from chemotherapy that is caused by low levels of erythropoietin."
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
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 nurse administers interferon alpha-2b to a patient. Which assessment finding will the nurse act on immediately?
The patient has elevated liver function tests.
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
The nurse prepares to administer a dose of interferon to a client. Which information in the client's electronic health record will prompt the nurse to question giving the medication?
urinary tract infection
A male client is prescribed interferon. What is his probable diagnosis?
viral hepatitis
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."
The nurse instructs a client about interferon alpha-2b prescribed to treat leukemia. Which client statement indicates that teaching has been effective?
"I will get a dose of the medication three times a week."
Mr. Harrison, 68 years old, who has renal carcinoma, is taking interleukin-2. What statement by this client leads you to believe that he has understood the teaching that you have done?
"This drug will inhibit tumor growth."
A patient has an 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
In learning about immunostimulants, what would you learn is an expected outcome of these medications?
Decreased numbers or severity of infections
The nurse is caring for a client who had a postpartum hemorrhage 2 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?
Determine if the client is taking iron supplements.
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.
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)
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 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
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
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
A nurse is caring for a 73-year-old male client scheduled to undergo chemotherapy. What drug would the nurse expect to be ordered to prevent infection in this client?
Pegfilgrastim (Neulasta)
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
What information is accurate when teaching about interleukins?
Some interleukins stimulate the growth of stem cell precursors of blood cells.
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
After assessing the client receiving erythropoietin drug therapy, the nurse suspects what finding is an adverse effect of erythropoietin drug therapy?
The client has peripheral edema to the feet and lower legs.
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 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
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
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
The nurse improves client compliance with the drug regimen of epoetin alfa through what intervention?
helping the client set up a reminder system for days when the drug is to be administered
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
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
The nurse is planning to visit the home of a client who will begin receiving interferon alpha-2b as treatment for hairy cell leukemia. Which laboratory values should the nurse confirm have prescribed before administering the medication? Select all that apply.
platelet count liver function tests renal function tests cbc
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? You Selected:
temporarily withholding administration
A client has chronic renal failure. As the disease progresses, the client is experiencing increasing shortness of breath, due to anemia. The nurse would anticipate which medication order?
Epoetin alfa
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."
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."
