Pharm 201 Chapter 51
A nurse is teaching a client about an iron supplement. Which should be included in the teaching a client about this medication?
It should be taken on an empty stomach.
A client is prescribed filgrastim. Which is the nurse's <b>best</b> explanation of how this drug works?
It stimulates growth and production of WBCs to fight off infection.
The nurse educator is teaching an online pharmacology class. The topic of the online seminar is the contraindications for the use of colony stimulation factor. The nurse includes which contraindication?
Known hypersensitivity
The nurse educator is teaching students regarding different types of immunostimulant drugs. When discussing lab values associated with the administration of these drugs, which cell counts should the nurse tell the students to expect?
Low platelet and low white blood cell count.
An adult male client experienced a kidney transplant 2 days ago, and his regimen of antirejection drugs began just prior to surgery. What nursing action should be integrated into this client's plan of care?
Place the client in a single, protective isolation room.
A 42-year-old client is experiencing chemotherapy-induced thrombocytopenia. The nurse is providing information to the client regarding the medication oprelvekin. Which information would the nurse include in the explanation?
"Chemotherapy has caused you to have a low platelet count, which puts you at risk for bleeding. Oprelvekin is used to increase platelet production to decrease the risk."
The nurse is teaching a novice nurse hire how to administer colony-stimulating factors. It is important to include which of the following information?
"Colony-stimulating factors are fragile and must be mixed before administration."
A 72-year-old client has been diagnosed with iron deficiency anemia. The client comes to the clinic for the nurse to teach the recommended way to take the iron supplement. Which of the following information would the nurse include in the client's teaching plan?
"Take this drug with water on an empty stomach."
The nurse is caring for a client diagnosed with rheumatoid arthritis (RA) who recently underwent a liver transplant. What immunosuppressant could this client be prescribed that would treat both diagnoses?
Anakinra (Kineret)
The nurse is discussing adverse reactions involving the cardiovascular system after administration of oprelvekin. The nurse would include which reactions in the client teaching plan?
Arrhythmia
A client is scheduled for renal transplantation. At what point in the client's care should the first dose of sirolimus (Rapamune) be given?
As soon as possible after the transplant
The nurse is caring for an older adult receiving immune modulators. What are appropriate actions by the nurse? Select all that apply.
Assess carefully for infection. Obtain baseline liver function studies and monitor follow-up studies. Determine dosage based on renal and liver function.
The nurse educator is teaching a class of students about the actions and uses of colony stimulating factor. The nurse should inform students CSF is indicated for what secondary problem related to cancer treatment?
Chemotherapy-induced neutropenia
A nurse is teaching a client about immunosuppressants. Which common adverse reactions of immunosuppressants should be included in the teaching? (Select all that apply.)
Chills Headache Fever
In addition to autoimmune disorders, immunosuppressant medications are used to treat which disorder?
Crohn's disease
A client is receiving oprelvekin. What assessment finding would lead the nurse to suspect that the client is experiencing a severe hypersensitivity reaction? Select all that apply.
Dyspnea Difficulty swallowing
Which of the following drugs act on the hematopoietic cells to stimulate proliferation, differentiation, and maturation of white blood cells? (Choose one)
Filgrastim (Neupogen)
A client is receiving omalizumab to treat allergic asthma, which is not relieved by inhaled corticosteroids. Which nursing intervention is appropriate with each dose administration of omalizumab?
Have epinephrine available during administration.
A client comes to the clinic asking what hematopoiesis means. How should the nurse explain this to the client?
Hematopoiesis means undifferentiated stem cells are stimulated to become specific blood cells.
The nurse monitors the client receiving eculizumab for what serious potential adverse effect?
Hemolysis
A nurse is caring for a client with a nursing diagnosis of Imbalanced Nutrition: Less Than Body Requirements related to iron deficiency. Which instructions should the nurse offer the client when providing care?
Increase intake of lean red meats.
The nurse administers aldesleukin to a client diagnosed with renal cell carcinoma. When assessing the client five days later, what abnormal findings should the nurse most likely attribute to the medication? Select all that apply.
Increased lymphocyte count Increased platelet count Irregular pulse rate
The nurse is providing education to clients who are required to take B12 due to deficiency anemia. The nurse should discuss the role of which body substance responsible for absorption of this vitamin?
Intrinsic factor
In reviewing a client's record, the nurse observes that the health care provider suspects a Vitamin B12 deficiency. What test is used to diagnosis a vitamin B12 deficiency?
Schilling test
A client is receiving an IV immune stimulant and develops a cardiac arrhythmia. What is the nurse's priority action?
Stop the drug immediately.
The nurse is providing care for a client who has chronic hepatitis C. The client has recently been prescribed peginterferon alfa-2b. What is the nurse's most appropriate action?
Teach the client how to self-administer subcutaneous injections
The nurse is caring for a client who has a diagnosis of chronic hepatitis B and has been prescribed an immune stimulant. The client provides client education. How would the nurse evaluate the effectiveness of the teaching plan?
The client can state specific measures to avoid adverse effects.
The nurse is caring for a client who has a diagnosis of chronic hepatitis B and has been prescribed an immune stimulant. The client provides client education. How would the nurse evaluate the effectiveness of the teaching plan? You Selected:
The client can state specific measures to avoid adverse effects.
A nurse is assigned to care for a client with iron deficiency anemia who is prescribed iron therapy. Which should the nurse confirm to ensure that iron compounds are not contraindicated in this client?
The client does not have hemochromatosis.
A client has undergone bone marrow transplant for the treatment of multiple myeloma. The client has been prescribed filgrastim (Neupogen) 6 mcg/kg IV daily. What outcome should indicate successful medication therapy to the nurse?
The client remains free of infection
A client's health care provider has concluded the client is likely to benefit from treatment with a monoclonal antibody. The success or failure of treatment will primarily depend on what variable?
The match between target cell receptor sites and the monoclonal antibody
A nurse is reviewing laboratory values of a client who has a urinary tract infection. Which cells protect the body from microorganisms?
WBCs
The nurse has administered a client's prescribed daily dose of filgrastim. When assessing for a therapeutic effect, what laboratory finding should the nurse prioritize?
White cell differential
A client asks what neutropenia is. Which is the nurse's <b>best</b> response?
a condition when the neutrophil level is very low
A client is diagnosed with anemia. The nurse understands that anemia can result in which effect?
decreased platelet production
A client who is receiving an immune suppressant has been admitted to the hospital unit. What action should the nurse prioritize?
Place the client on protective isolation.
To help understand immunostimulant drug therapy, the client has come to the clinic for a class on thrombopoiesis. The nurse explains that the term means the formation of which types of blood cells?
Platelets
The nurse is providing care for a client whose current medications include tacrolimus (Prograf). The nurse should anticipate that this client is likely to be taking what medication concurrently?
Prednisone
The nurse is reviewing laboratory values of client who has a respiratory illness. Which cells supply oxygen to the tissues?
RBC's
What common adverse reactions of tacrolimus should the nurse teach the client? (Select all that apply.)
tremors hair growth gum hyperplasia
The nurse is caring for a client who is receiving parenteral administration of an iron supplement. During administration, the nurse will monitor and report which of the following adverse reactions immediately?
Dyspnea, urticaria, rashes, itching, and fever
A client has a low white blood cell count and is concerned about acquiring an infection. The client will not sign the informed consent due to a knowledge deficit about the CSF. How should the nurse respond?
"Chemotherapy kills cancer cells as well as good cells needed to prevent and control infection. The cells are called white blood cells that grow in stages but are not effective until the cell is in the adult stage. A colony-stimulating drug acts on these cells to stimulate growth to the mature adult white blood cell stage, so that the cells can go to work to help protect you from infection."
A female client has been admitted to the emergency department in distress and the nurse's review of the client's medication administration record reveals that the client takes cyclosporine and mycophenolate. What is the nurse's most appropriate assessment question for the client's family members?
"Has she ever been the recipient of a tissue transplant?"
The nurse is preparing to administer oprelvekin to a client diagnosed with a chemotherapy-induced bleeding disorder. The nurse is explaining to the client the reason for administering this drug? Which explanation is best?
"The drug is used to increase platelet count during chemotherapy."
The nurse learns that a client in a clinic is taking folic acid to treat an associated anemia. The client decided to go on a fasting diet for the last two weeks to lose weight before her daughter's wedding. How would the nurse explain the importance of staying on the diet that the provider prescribed last month?
"The prescribed diet and drug are necessary to correct anemia associated with folic acid deficiency."
The nurse is teaching a client about macrocytic anemia. Which of the following information would the nurse include in the teaching plan?
"This is an anemia that results from the abnormal formation of erythrocytes."
After a client age 65 years diagnosed with vitamin B12 deficiency learns about the use of the vitamin, she asks the nurse what caused her B12 deficiency anemia. Which of the following statements would the nurse use when teaching the client about vitamin B12?
"You have a deficiency because you are on a strict vegan diet."
The nurse is administering colony-stimulating factors to an older adult client after chemotherapy. The nurse should explain to the client that this medication is being administered for which reason?
"Your body is going to have trouble fighting off infections on it's own. This medication will help with that."
Which of these conditions or lifestyle choices would put clients at risk for developing a B12 deficiency? Select all that apply.
vegan lifestyle gastric cancer ulcerative colitis
A client comes to the clinic to learn about pernicious anemia. What would the nurse include in the lesson plan?
Avoid contact with infectious disease.
What are important precautions a nurse should teach a client receiving an immunosuppressant? (Select all that apply.)
Avoid crowds. Take precautions to avoid getting pregnant. Keep follow-up appointments for laboratory assessments.
A female client 50 years of age has a history of an allergy to cyanocobalamin. Based on the history, the nurse knows which of the following vitamins is contraindicated?
B12
A 72-year-old male client has arrived at the outpatient unit to receive an infusion of alemtuzumab (Compath). The client tells the nurse this is the second time his chronic lymphocytic leukemia has relapsed and the second time he will receive this drug because he failed alemtuzumab therapy after being treated with an alkylating agent. What is the priority nursing action?
Confirming the order with the prescriber
The nurse is caring for a female client, aged 62, who has been admitted for treatment of metastatic melanoma. What agent would the nurse anticipate the client is likely to order?
Ipilimumab
A student nurse is preparing to administer an oral iron supplement to a client diagnosed with iron deficiency anemia. The supervising nurse should question the student regarding which interaction caused when iron and antibiotics are used together for treatment?
Iron causes a decreased gastrointestinal absorption of the antibiotic.
A client diagnosed with anemia asks what the cause of anemia is. Which is the nurse's <b>best</b> response?
It is caused by a decrease in the number of RBCs.
A client has a successful liver transplant. The nurse should advise the client prescribed oral cyclosporine to avoid mixing the drug with what form of liquid?
any type of grapefruit juice
A client with iron deficiency is prescribed iron dextran. Based on the nurse's understanding of this drug, the nurse would expect to administer it cautiously to a client with which condition?
asthma
The nurse is assessing a client during a home health visit. The client asks how interferon works. The nurse should inform the client that interferon works by:
controlling cellular proteins.
A client suffering from anemia resulting from chronic kidney disease might be treated with which drugs?
epoetin alfa
When describing the various types of blood cells, which cell type would the instructor describe as supplying our cells with oxygen from the lungs?
erythrocytes
Which are common adverse reactions that is included in teaching a client about epoetin? Select all that apply.
fatigue nausea headache
A client is prescribed which drug that acts on the hematopoietic cells to stimulate proliferation, differentiation, and maturation of white blood cells?
filgrastim
A client is ordered to receive cyclosporine intravenously, and the nurse has explained the need for frequent blood work. This blood work is required because cyclosporine:
has a narrow therapeutic range.
A nurse is describing the process by which the body is stimulated to make more of a specific type of blood cells. The nurse is describing which process?
hematopoiesis
Filgrastim (Neupogen) should be used cautiously in clients with which medical conditions?
hypothyroidism
A group of nursing students demonstrate understanding of blood cells when they identify which cell as responsible for controlling the bleeding from microscopic to major tears in our tissues?
megakaryocytes
A nurse is reviewing the laboratory values of a client admitted for gastrointestinal bleed. Which cells control bleeding?
platelets
Oprelvekin is a drug that stimulates the process of making which blood cells?
platelets
An older adult woman has experienced a sharp decline in her mobility and quality of life due to severe rheumatoid arthritis. As a result, her care provider has recently prescribed abatacept. This fusion protein inhibitor will achieve a therapeutic effect by what means?
preventing the activation of T cells
Which conditions in a client's history should the nurse report to the health care provider who prescribed epoetin alfa? Select all that apply.
seizures hypertension congestive heart failure
Mycophenolate mofetil is being considered in the treatment of a 39-year-old female transplant recipient. Before the initiation of therapy, the nurse must assess the client for what information to ensure safety?
the fact that the client is not pregnant
