Nokea
A client is prescribed ferrous sulfate (Feosol). Which of the following adverse reactions should the nurse discuss with a client prior to the administration of this drug? Select all that apply.
- A. Constipation
- B. Fluid retention
- C. Nausea
- D. Fatigue
- E. Dark stools
Correct Answer: A,C,E
Rationale: GI irritation, nausea, vomiting, constipation, diarrhea, darker stools, headache, backache, and allergic reactions are adverse reactions the nurse should discuss with a client prior to the administration of ferrous sulfate (Feosol).
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A client who is prescribed an iron preparation for treating iron deficiency anemia tells the nurse that she has also been taking ascorbic acid. The nurse would assess the client for which of the following?
- A. An increase in seizure activity
- B. Signs of vitamin B12 deficiency
- C. Increased absorption of iron
- D. Signs of folate deficiency
Correct Answer: C
Rationale: The nurse should monitor for an increased absorption of iron in the client due to the interaction of ascorbic acid with the iron preparation. An increase in seizure activity may occur when folic acid is administered with the hydantoins. Signs of folate deficiency may occur when sulfasalazine is administered concurrently. Vitamin B12 deficiency is a rare deficiency caused by a low dietary intake.
Prior to administering a drug used to treat anemia, the nurse should assess a client's vital signs, ability to carry out activities of daily living, and general appearance, and for the presence of which of the following other general symptoms? Select all that apply.
- A. Fatigue
- B. Pallor
- C. Headache
- D. Shortness of breath
- E. Sore tongue
Correct Answer: A,B,C,D,E
Rationale: Prior to administering a drug used to treat anemia, the nurse should assess a client's vital signs, client's ability to carry out activities of daily living, and client's general appearance, and for the presence of other general symptoms including fatigue, shortness of breath, sore tongue, headache, and pallor.
A client is receiving a colony-stimulating factor and experiences dilutional anemia secondary to fluid retention associated with drug therapy. The nurse would most likely identify which nursing diagnosis?
- A. Fatigue
- B. Constipation
- C. Imbalanced Nutrition: Less Than Body Requirements
- D. Anxiety
Correct Answer: A
Rationale: During administration of the CSF drugs, the patient may experience fluid retention. The increase in fluid volume makes the ratio of cells to fluid in the blood less, which results in a dilutional anemia. The patient may experience fatigue due to this anemia. Constipation is more likely when iron supplements are used. Imbalanced Nutrition: Less Than Body Requirements would be more likely if the client was experiencing anemia. There is no evidence to suggest Anxiety as a nursing diagnosis.
A client who was treated for anemia is being discharged. The client has been instructed to continue with epoetin alfa for a week. Which of the following points should the nurse include in the teaching plan to educate the client about the therapy when caring for the client on an outpatient basis?
- A. Avoid use of multivitamin preparations.
- B. Report signs of joint pain to the primary health care provider.
- C. Follow the recommended diet provided by the primary health care provider.
- D. Take the drug on an empty stomach or with water.
Correct Answer: B
Rationale: When caring for a client who is to take epoetin alfa for anemia, the nurse should instruct the client to report any signs of joint pain, dizziness, headache, fatigue, nausea, vomiting, or diarrhea to the primary health care provider. The nurse should instruct the client to avoid taking multivitamin preparations and to follow the diet recommended by the primary health care provider when caring for a client who has to take folic acid. The nurse should instruct the client to take the drug on an empty stomach or with water when caring for a client who has to take iron supplements on an outpatient basis.
A client with chronic kidney disease is prescribed epoetin alfa (Procrit). Which of the following would be appropriate for the nurse to do when administering this drug to promote optimal response? Select all that apply.
- A. Shake the vial vigorously prior to administration.
- B. Use the vial for multiple doses.
- C. Discard any unused portion after administration.
- D. Administer the drug either intravenously or subcutaneously.
- E. Avoid using the drug if the client is receiving dialysis.
Correct Answer: C,D
Rationale: When administering epoetin alfa (Procrit) to a client with chronic kidney disease, the following apply: the drug is given three times weekly IV or subcutaneously, if the client is receiving dialysis, the drug is administered into the venous access line, the drug is mixed gently during preparation for administration; shaking may denature the glycoprotein; and the vial is used for only one dose and any remaining or unused portion is discarded.