Chap 49 PrepU

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

The mature red blood cell contains a nucleus.

False

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

The nurse administers epoetin alfa (Epogen). What is the therapeutic response the nurse expects to assess?

Increased red blood cell count

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 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

The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the physician to order for this client?

Iron supplement

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

Cyanocobalamin is a vitamin B12 in a nasal formulation.

True

A male client is prescribed interferon. What is his probable diagnosis?

Viral hepatitis

When administering iron injections, which method would the nurse use?

Z-track intramuscular

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

A male client is diagnosed with severe neutropenia. The physician prescribes filgrastim. What is the desired effect?

To increase white blood cells

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."

The nurse is mentoring a first-year nursing student while caring for a client with a disease that affects the hematopoietic system. The student looks confused and says "I've never heard of that system. What is it?" How would the nurse repond?

"The hematopoietic system is composed of fluid, red blood cells, white blood cells, and platelets."

Approximately what percentage of the body's red blood cells (RBCs) is destroyed and replaced each day?

1%

The average lifespan of a red blood cell (RBC) is approximately:

120 days

A patient is being treated for anemia with epoetin alfa (Epogen). Which of the following laboratory values should be assessed before and during treatment?

CBC

A patient who is HIV positive is receiving zidovudine 4,2000 mg/week and has an endogenous erythropoietin level of 350 mU/mL. What does the nurse anticipate will be administered for this patient?

Erythropoietin

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

When describing the function of vitamin B12, what would be appropriate to include?

Maintenance of myelin sheath

All hematopoietic and immune blood cells are derived from which cells in the bone marrow?

Stem cells

The component of the red blood cell that is not recycled is bilirubin.

True

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

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."

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."

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 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

Adverse effects of epoetin and darbepoetin include increased risks of what condition?

Myocardial infarction

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 IV

There is a risk of antibody production with the use of epoetin.

True

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.

The nurse is teaching a patient who is to receive epoetin alfa about possible adverse effects. Which would the nurse include? (Select all that apply.)

-Diarrhea -Asthenia -Vomiting

The nurse is assessing a patient diagnosed with anemia. What symptoms does the nurse expect to assess in the patient? (Select all that apply.)

-Elevated heart rate -Fatigue

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

Which would be appropriate for a client who is receiving iron therapy?

Cautioning the client that stool may be dark or green

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

A patient is receiving epoetin alfa (Epogen) for anemia. Which of the following adjunctive therapies are imperative with epoetin alfa?

Iron supplement

A client comes to the clinic asking what erythropoiesis means. The nurse would state that erythropoiesis is the process of making:

red blood cells

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

Which would a nurse identify as the primary issue associated with anemias?

Ineffective red blood cells

A patient has been prescribed epoetin alfa. The nurse recognizes that this medication is indicated for treatment of anemia associated with which disease process?

Renal failure

The nurse would contact the prescriber immediately if interferon was prescribed for which client?

11-month-old female with HIV acquired from her mother

A patient is to be administered an erythropoiesis-stimulating agent. Which of the following drugs would the nurse administer?

Epoetin alfa

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