Ch 49: Drugs Used to Treat Anemia
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."
A client is prescribed oral ferrous sulfate solution. Which statement by the client indicates that the client understands how to take the drug?
"I should drink the solution through a straw so my teeth don't get stained."
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 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."
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."
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."
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 respond?
"The hematopoietic system is composed of fluid, red blood cells, white blood cells, and platelets."
The nurse is assessing a patient diagnosed with anemia. What symptoms does the nurse expect to assess in the patient? (Select all that apply.)
- Fatigue - Elevated heart rate
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 - Increased hemoglobin
A client diagnosed with chronic renal failure is being treated with epoetin alfa in a home setting. The community health nurse should encourage the client to maintain a high intake of which food to supplement the intended action of the medication? Select all that apply.
- leafy green vegetables - red meat
The nurse would contact the prescriber immediately if interferon was prescribed for which client?
11-month-old female with HIV acquired from her mother
The average lifespan of a red blood cell (RBC) is approximately:
120 days.
A client is receiving epoetin alfa. The nurse understands that this drug's duration of effect would be which amount of time?
24 hours
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
Which client would likely be the most appropriate candidate for treatment with filgrastim?
A client whose acute myelogenous leukemia necessitated a bone marrow transplant
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
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?
Avoidance of infection
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 client with a diagnosis of renal failure is being treated for anemia with epoetin alfa. Frequent assessment of which laboratory values should be prioritized before and during treatment?
CBC
Which would be appropriate for a client who is receiving iron therapy?
Cautioning the client that stool may be dark or green
A client is experiencing iron toxicity. Which agent would the nurse expect to be given?
Deferoxamine
A client has been diagnosed with chronic renal failure. Which agent will assist in raising the client's hemoglobin levels?
Epoetin alfa
A patient is to be administered an erythropoiesis-stimulating agent. Which of the following drugs would the nurse administer?
Epoetin alfa
A 69-year-old 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?
Flulike symptoms
Colony-stimulating factors (CSF) are administered to produce which therapeutic effect?
Increase the growth of specific types of blood cells
A patient develops anemia secondary to chronic hemodialysis. The health care provider prescribes iron sucrose. The nurse expects this drug to be administered by which route?
Intravenous
A nurse preparing to administer an erythropoiesis-stimulating drug is aware that the drug can be given by which routes? Select all that apply.
Intravenous (IV) Subcutaneous
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
Which would the nurse encourage a client to consume to prevent folic acid anemia? (Select all that apply.)
Liver Milk Broccoli
When describing the function of vitamin B12, what would be appropriate to include?
Maintenance of myelin sheath
Adverse effects of epoetin and darbepoetin include increased risks of what condition?
Myocardial infarction
A client is receiving darbepoetin alfa. The nurse would inform the client that he will be receiving this drug at which frequency?
Once a week
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
The anemia that occurs with chronic renal failure is caused by the kidneys themselves. What inability of the kidneys causes anemia in chronic renal failure?
Produce erythropoietin
Cytokines regulate the immune response by stimulating or inhibiting the activation, proliferation, and differentiation of various cells and by what other action?
Regulating the secretion of antibodies
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
A patient is receiving hydroxyurea. The nurse understands that this drug is used to treat:
Sickle cell anemia
After reviewing the major types of anemia, students demonstrate understanding of the information when they identify what as an example of a hemolytic anemia?
Sickle cell anemia
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 Intravenous
Which symptom, if assessed after the administration of epoetin alfa (Epogen), would be cause for alarm?
The patient displays weakness on one side of the body.
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
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?
The potential benefits of epoetin alfa must be weighed carefully against the potential adverse effects in cancer patients.
A client taking epoetin alfa requests changing the medication from the subcutaneous route to the PO route. How should the nurse respond?
This medication is destroyed in the stomach and can only be given by injection.
Cyanocobalamin is a vitamin B12 in a nasal formulation.
True
The component of the red blood cell that is not recycled is bilirubin.
True
There is a risk of antibody production with the use of epoetin.
True
A male client is prescribed interferon. What is his probable diagnosis?
Viral hepatitis
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
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
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
An older adult client diagnosed with chronic renal failure has begun experiencing increasing fatigue. The nurse would anticipate educating the client on what likely medication prescription?
epoetin alfa
A client with an allergy to epoetin alfa should be provided with education regarding the addition of what other medication?
epoetin beta
A patient comes to the clinic reporting fatigue and pica. Laboratory findings reveal a low serum iron level and a low ferritin level. Upon evaluation of this assessment and laboratory data, the nurse suspects that the patient will be diagnosed with:
iron deficiency anemia.
What are the primary factors that contribute to the body's ability to fight off infection? Select all that apply.
normal hematopoiesis normal immune system function normal cardiovascular function
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?
temporarily withholding administration
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 mature red blood cell contains a nucleus.
False
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 client is receiving epoetin alfa for anemia. Which adjunctive therapy is imperative with epoetin alfa?
Iron supplementation
A client's current medical condition is suggestive of impaired erythropoiesis. Which laboratory study would be most clinically relevant in diagnosing this health problem?
RBC, hemoglobin, and hematocrit
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
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."
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
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 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 leucovorin administration.
What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?
Impaired tissue oxygenation related to anemia
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
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
The patient with chronic renal failure requires an agent to increase red blood cell production. What drug does the nurse anticipate administering?
Epoetin alfa
