hematological medications

A client is taking ticlopidine hydrochloride. The nurse should tell the client to avoid which substance while taking this medication?

Acetylsalicylic acid ticlopidine hydrochloride is a blood thinner It can prevent strokes by keeping blood clots from forming in the blood vessels. Aspirin, also known as acetylsalicylic acid (ASA) is an NSAID that also works as a blood thinner. you don't want to take 2 medications that will thin the blood this will increase risk for bleeding

The nurse is caring for a postpartum client with a diagnosis of deep vein thrombosis who is receiving a continuous intravenous infusion of heparin sodium. Review of which laboratory result is the most important by the nurse?

Activated partial thromboplastin time (aPTT)

The nurse is evaluating the results of laboratory studies for a client receiving epoetin alfa. When should the nurse expect to note a therapeutic effect of this medication?

After 2 weeks of therapy

A client with a subarachnoid hemorrhage needs to have surgery delayed until a stable clinical condition is achieved. The nurse prepares to administer which medication as prescribed to prevent clot breakdown and dissolution?

Aminocaproic acid Aminocaproic acid is an antifibrinolytic agent that prevents clot breakdown or dissolution. It is commonly prescribed after subarachnoid hemorrhage if surgery is delayed or contraindicated, to prevent further hemorrhage

A client is scheduled to have heparin sodium 5000 units subcutaneously. What is the most appropriate nursing intervention?

Avoid aspirating prior to injecting the medication. Aspiration should be avoided before injecting the heparin because it can cause hematoma at the administration site

A home care nurse is visiting a client who was discharged to home with a prescription for continued administration of enoxaparin subcutaneously. What is the nurse's priorityassessment for this client?

Bleeding gums or bruising Enoxaparin is an anticoagulant. An adverse effect of anticoagulant therapy is bleeding. Accordingly, the nurse questions the client about signs and symptoms that could indicate bleeding, such as bleeding gums, bruising, hematuria, or dark, tarry stools.

A client who is scheduled to have warfarin sodium therapy has a prothrombin time (PT) of 28 seconds (28 seconds). What is the most appropriate nursing intervention at this time?

Call the health care provider (HCP). the normal PT is 11 to 12.5 seconds (11 to 12.5 seconds). A PT of 28 seconds represents an elevated value. The nurse should withhold the next dose and notify the HCP.

A client having a myocardial infarction is receiving alteplase therapy. Which action should be carried out by the nurse to monitor for the most frequent side/adverse effect?

Check for signs of bleeding. Alteplase (t-PA) Alteplase is a thrombolytic medication, which means that it breaks down or dissolves clots; therefore, bleeding is a concern

A client with chronic kidney disease is receiving ferrous sulfate. The nurse instructs the client that which finding is a common side/adverse effect associated with this medication?

Constipation Ferrous sulfate is an iron supplement used to treat anemia. Constipation is a frequent and uncomfortable side effect

The nurse is caring for a client who was just admitted to the hospital for the treatment of iron overload. The nurse anticipates that the health care provider will prescribe which medication to treat the iron overload?

Deferoxamine Deferoxamine is a medication used to treat iron overload

A client is scheduled to have alteplase. Which item should the nurse obtain to monitor side/adverse effects of the medication therapy?

Occult blood test strips Bleeding is a frequent and potentially severe adverse effect of therapy. The nurse assesses for signs of bleeding in clients receiving this therapy using occult blood test strips to test urine, stool, or nasogastric drainage

The nurse provides instructions to a client who has a prescription for ticlopidine. Which statement made by the client indicates a need for further teaching?

"Food will affect the medication, so I need to take the medication on an empty stomach." Ticlopidine is best tolerated when taken with meals.

The nurse has provided instruction to a client with chronic kidney disease who has a prescription for epoetin alfa. Which statement by the client indicates that teaching was effective?

"I have to receive this medication subcutaneously. Epoetin alfa is administered parenterally by the intravenous or subcutaneous route.

The nurse is reviewing the laboratory results for a client who arrives at the health care clinic for follow-up assessment after being diagnosed with atrial fibrillation. The international normalized ratio (INR) is analyzed because the client has been taking warfarin sodium since discharge from the hospital. The nurse determines that the INR range is at an appropriate level if what value is noted on the laboratory report?

2.3 The recommended INR range for warfarin sodium therapy for atrial fibrillation is 2.0 to 3.0

The nurse is monitoring the laboratory test results for a client who is taking warfarin sodium after mechanical heart valve replacement. The nurse should expect the international normalized ratio (INR) for this client to be at what value in order to be therapeutic?

3.0 The normal value for INR is 0.81 to 1.2 The target INR or therapeutic level for a client receiving warfarin sodium is 2.5 to 3.5

A client is prescribed a liquid iron preparation that has the potential to stain the teeth. The nurse should instruct the client to take which action to prevent staining of the teeth?

Dilute the iron in juice, drink it through a straw, and rinse the mouth afterward.

The nurse is preparing to administer filgrastim by intravenous (IV) infusion. Which nursing action is the most appropriate for administering this medication?

Dilute the medication in 5% dextrose in water (D5W). Filgrastim may be administered by continuous IV infusion. It is diluted only with D5W when administered by the IV route.

A client is receiving heparin sodium by continuous intravenous (IV) infusion. The nurse should notify the health care provider if ongoing nursing assessment reveals which finding?

Ecchymosis The client who receives a continuous IV infusion of heparin sodium is at risk for bleeding. The nurse assesses for signs/symptoms of bleeding, which include bleeding from the gums, ecchymosis on the skin, cloudy or pink-tinged urine, tarry stools, and body fluids that test positive for occult blood

The client in chronic kidney disease is receiving epoetin alfa. The nurse should monitor this client for which side/adverse effect of this medication?

Hypertension Epoetin alfa is generally well tolerated, although hypertension can occur and is the most significant adverse effect.

The nurse is monitoring a client who is receiving epoetin alfa for adverse effects of the medication. Which finding indicates a side/adverse effect?

Hypertension The most significant adverse effect is hypertension, and its use is contraindicated in uncontrolled hypertension.

The nurse is preparing to administer filgrastim to a client with a diagnosis of agranulocytosis. The client asks the nurse about the purpose of the medication. Which information should the nurse include in the response regarding action of this medication?

It promotes the growth of neutrophils. It is administered to clients with agranulocytosis to promote the growth of neutrophils and enhance the function of mature neutrophils.

The nurse is reviewing the health care provider's (HCP's) prescriptions for a client recently admitted to the hospital and notes that the HCP has prescribed ticlopidine therapy. Which finding on the client's record would indicate a need to contact the HCP before initiating the medication prescription?

Neutropenia Neutropenia, or agranulocytosis, is the most serious adverse effect associated with the use of ticlopidine. If a diagnosis of neutropenia is determined, the client will be withdrawn from therapy.

The nurse is reviewing the laboratory test results for a client who is receiving filgrastim. Which reported value would indicate an effective response to this medication?

Neutrophil count of 10,000 mm3 (10 × 109/L) Treatment is continued until the absolute neutrophil count reaches 10,000

The nurse is caring for a client who is receiving heparin sodium intravenously as a continuous infusion. Which laboratory finding requires immediate nursing intervention?

Platelet count of 100,000 mm The platelet count indicates that the client receiving heparin sodium is at risk for heparin-induced thrombocytopenia (HIT). HIT should be suspected whenever platelet counts fall below normal. If severe thrombocytopenia develops (platelet count less than 100,000 heparin sodium should be discontinued.

Enoxaparin sodium is prescribed for a client after hip replacement surgery. Which medication should the nurse anticipate to administer in the event of enoxaparin sodium overdose?

Protamine sulfate Enoxaparin sodium is an anticoagulant. Accidental overdose of this medication may lead to bleeding complications. The antidote is protamine sulfate.

A client receiving heparin sodium by continuous intravenous (IV) infusion removes the tubing from the pump to change his hospital gown. The nurse is concerned that the client received a bolus of medication. After requesting a prescription for a stat partial thromboplastin time (PTT), the nurse should check for the availability of which medication in the medication cart?

Protamine sulfate protamine sulfate the antidote for heparin sodium

A client is being discharged to home with enoxaparin for short-term therapy. What should the nurse explain to the family about the medication action?

Reduces the risk of deep vein thrombosis Enoxaparin is an anticoagulant that is administered to prevent deep vein thrombosis and thromboembolism in clients at risk

A client is scheduled to take ticlopidine. The nurse plans to take which action before implementing this medication therapy?

Review the results of the complete blood cell (CBC) count. Ticlopidine also can cause neutropenia, which is an abnormally small number of mature white blood cells (WBCs). Baseline data from a CBC count are necessary before implementation of therapy, and the nurse should monitor for neutropenia during this medication therapy.

A client has a prescription to receive enoxaparin. The nurse should plan to administer this medication by which route?

Subcutaneous

The nurse is preparing to administer filgrastim to the client. Which route of administration should the nurse determine is the most appropriate for this medication?

Subcutaneous

A client is diagnosed with iron deficiency anemia, and ferrous sulfate is prescribed. The nurse should tell the client that it would be bestto take the medication with which food?

Tomato juice to take the medication with orange juice or another vitamin C-containing product or a product high in ascorbic acid to increase the absorption of the iron. Among the options presented, tomato juice is highest in vitamin C and ascorbic acid.

The nurse is preparing to administer heparin sodium subcutaneously. Which nursing action is the most appropriate?

Use a 25- to 26-gauge, ⅝-inch (1.5 cm) needle

Granisetron is an antiemetic.

an antiemetic medication It can prevent nausea and vomiting

Ketoconazole

an antifungal medication

some antiemetic medication

dolasetron (Anzemet) granisetron (Kytril) ondansetron (Zofran) palonosetron (Aloxi) notice the stern ending not all antiemetics end in setron though

terbinafine

it can treat fungal infections on the skin, including athlete's foot, ringworm, and "jock itch."

The home care nurse is making a monthly visit to a client with a diagnosis of pernicious anemia who has been receiving a monthly injection of cyanocobalamin. Before administering the injection, the nurse evaluates the effects of the medication and determines that a therapeutic effect is occurring if the client makes which statement?

"I feel stronger and have a much better appetite." Symptoms can include weakness, fatigue, anorexia, loss of taste, and diarrhea. To correct deficiencies, a crystalline form of vitamin B12, cyanocobalamin, can be given intramuscularly

The nurse is providing instructions to the parent of a child with iron deficiency anemia about the administration of a liquid oral iron supplement. Which statement, if made by the parent, indicates an understanding of the administration of this medication?

"I should use a medicine dropper and place the iron near the back of the throat." An oral iron supplement should be administered through a straw or medicine dropper placed at the back of the mouth because it will stain the teeth.

A health care provider prescribed ticlopidine to the client with thrombotic stroke. The nurse provides instructions to the client and spouse regarding the medication. Which statement made by the client indicates that education was effective?

"I'll take the medicine with meals." The most common side effects are gastrointestinal (GI) disturbances. Taking ticlopidine with meals tends to lessen those effects.

The nurse has provided instructions to a client who will receive alteplase for the treatment of acute myocardial infarction. The nurse determines that teaching was effective if the client states that the main action of alteplase is what?

"It will dissolve any clots that are obstructing the coronary arteries."

The nurse has given the client with atrial fibrillation instructions to take one 1 aspirin daily. The client says to the nurse, "Why do I need to take this? I don't get any pain with my heart rhythm."Which response by the nurse is the most appropriate?

"This will help prevent clot formation in your heart as a result of your heart's rhythm."

A client is admitted to the hospital emergency department with an acute anterior wall myocardial infarction. The nurse discusses thrombolytic therapy with the client and spouse. The spouse is concerned about the dangers of this treatment. Which statement by the nurse is appropriate?

"You have concerns about whether this treatment is the best option.

A nurse has provided discharge instructions to a client being placed on long-term anticoagulant therapy with warfarin sodium. Adequate learning would be evident if the client makes which statements? Select all that apply.

- "I will inform my dentist that I am taking this medication." - "I will have my blood levels checked as prescribed by my health care provider (HCP)." - "I will report any signs of blood in my urine or stool to my health care provider (HCP)."

A client with chronic kidney disease is receiving epoetin alfa for the past 2 months. What should the nurse determine is an indicator that this therapy is effective?

An increase in serum hematocrit Epoetin alfa stimulates red blood cell production. Initial effects should be seen within 1 to 2 weeks, and the hematocrit reaches normal levels in 2 to 3 months.

A client is admitted to the hospital with a diagnosis of myocardial infarction (MI). The client is started on alteplase therapy. The nurse determines that teaching has been effectivewhen the client's significant other states that the purpose of the medication is to perform which action?

Dissolve any clots in the coronary arteries.

A postpartum client with deep vein thrombosis is being treated with anticoagulant therapy. The nurse teaches the client that the health care provider (HCP) should be contacted for which noted side and adverse effects? Select all that apply.

- Epistaxis (nosebleed) - Hematuria ( blood in urine) - Ecchymosis (bruise bleeding under the skin due to trauma) The treatment for deep vein thrombosis is anticoagulant therapy. The nurse assesses for bleeding

The nurse has a prescription to administer a dose of iron by the intramuscular route to the client. What are the most appropriate nursing actions? Select all that apply.

- Use a Z-track method. - Use an air lock when drawing up the medication. - Change the needle after drawing up the dose and before injection.

The nurse is providing discharge instructions to a client taking warfarin sodium. Which statement, based on health care provider (HCP) permission, is appropriate to include in client teaching for this medication?

"You need to check with your doctor about what can be taken for headache." Because the medication places the client at risk for bleeding, the client is instructed to avoid salicylates (acetylsalicylic acid, or aspirin) and alcohol.

The nurse is preparing to administer phytonadione to the client. Which laboratory value should the nurse monitor in order to evaluate the effectiveness of the medication?

Prothrombin time Phytonadione (vitamin K) is needed for adequate blood clotting. Therefore, checking the prothrombin time is necessary 24 hours after injection of this medication