Nokea
A 2-year-old child will be receiving ferrous sulfate oral drops (Fer-Iron) 5 mg/kg/day in three divided doses. The child weighs 30 pounds. Identify how many milligrams the nurse will administer per dose. (Record answer using one decimal place.)
Correct Answer: 22.7 mg
Rationale: Convert pounds to kilograms: 30 ?· 2.2 = 13.6 kg. Calculate the total dose per day: 5 mg/kg/day ?? 13.6 kg = 68 mg/day. Divide into 3 doses: 68 mg/day ?· 3 doses/day = 22.67, rounded to 22.7 mg/dose.
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A patient with end-stage renal failure has been admitted to the hospital for severe anemia. The patient is refusing blood transfusions. The nurse anticipates drug therapy with which drug to stimulate the production of red blood cells?
- A. Folic acid
- B. Cyanocobalamin
- C. Epoetin alfa
- D. Filgrastim
Correct Answer: C
Rationale: Epoetin alfa is a colony-stimulating factor that is responsible for erythropoiesis, or formation of red blood cells.
The nurse is administering intravenous iron dextran for the first time to a patient with anemia. After giving a test dose, how long will the nurse wait before administering the remaining portion of the dose?
- A. 30 minutes
- B. 1 hour
- C. 6 hours
- D. 24 hours
Correct Answer: B
Rationale: Although anaphylactic reactions usually occur within a few moments after the test dose, it is recommended that a period of at least 1 hour elapse before the remaining portion of the initial dose is given.
A patient will be taking oral iron supplements at home. The nurse will include which statements in the teaching plan for this patient? (Select all that apply.)
- A. Take the iron tablets with meals to reduce GI upset.
- B. Take the iron tablets on an empty stomach 1 hour before meals.
- C. Take the iron tablets with an antacid to prevent heartburn.
- D. Drink 8 ounces of milk with each iron dose.
- E. Taking iron supplements with orange juice enhances iron absorption.
- F. Stools may become loose and light in color.
- G. Stools may become black and tarry.
Correct Answer: A,E,G
Rationale: Iron tablets need to be taken with meals to reduce gastrointestinal distress, but antacids and milk interfere with absorption. Orange juice enhances the absorption of iron. Stools may become black and tarry in patients who are on iron supplements. Tablets need to be taken whole, not crushed, and the patient needs to be encouraged to eat foods high in iron.
A nurse is giving instructions to a patient who will be receiving oral iron supplements. Which instructions will be included in the teaching plan?
- A. Take the iron tablets with milk or antacids.
- B. Crush the pills as needed to help with swallowing.
- C. Take the iron tablets with meals if gastrointestinal distress occurs.
- D. If black tarry stools occur, report it to the doctor immediately.
Correct Answer: C
Rationale: Although taking iron tablets with food may decrease absorption, doing so helps to reduce gastrointestinal distress. Antacids and milk may cause decreased iron absorption; iron tablets must be taken whole and not crushed. Black, tarry stools are expected adverse effects of oral iron supplements.
An oral iron supplement is prescribed for a patient. The nurse would question this order if the patient's medical history includes which condition?
- A. Decreased hemoglobin
- B. Hemolytic anemia
- C. Weakness
- D. Concurrent therapy with erythropoietics
Correct Answer: B
Rationale: Iron supplements are contraindicated in anemias that are not caused by iron-deficiency, such as hemolytic anemia. Decreased hemoglobin and weakness are related to iron-deficiency anemia. Iron supplements are given with erythropoietic drugs to aid in the production of red blood cells.