Nokea
A client receives filgrastim to treat neutropenia associated with chemotherapy. The nurse monitors the client's absolute neutrophil count (ANC). The nurse anticipates stopping the drug when the ANC reaches which level?
- A. 2500/mm³
- B. 5000/mm³
- C. 7500/mm³
- D. 10000/mm³
Correct Answer: D
Rationale: Injections of the CSF filgrastim are started at least 24 hours after the completion of a cycle of chemotherapy. The absolute neutrophil count (ANC) is monitored and therapy is continued until an ANC count of at least 10,000/mm³ is achieved.
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Based on the nurse's understanding of epoetin alfa, the nurse would expect to administer the drug cautiously to a client with a history of which of the following? Select all that apply.
- A. Diabetes
- B. Renal failure
- C. History of seizures
- D. Congestive heart failure
- E. Hypotension
Correct Answer: C,D
Rationale: Epoetin alfa (Procrit) is used cautiously in clients with hypertension, heart disease, congestive heart failure, or a history of seizures.
A nurse administers a test dose of iron dextran IM. The nurse would wait at least how long before administering the remainder of the dose?
- A. 15 minutes
- B. 30 minutes
- C. 45 minutes
- D. 60 minutes
Correct Answer: D
Rationale: After giving the test dose, the nurse would monitor the client for an allergic response for at least 1 hour after the test dose and before administering the remaining dose. Epinephrine is kept on standby in the event of severe anaphylactic reaction.
A client is prescribed ferrous sulfate. Before administering the drug, the nurse reviews the client's medical record. The nurse would withhold the drug and contact the primary health care provider if the client's history revealed which of the following? Select all that apply.
- A. Hemolytic anemia
- B. Vitamin B12 deficiency anemia
- C. Anemia of chronic kidney disease
- D. Hemochromatosis
- E. Hypertension
Correct Answer: A,D
Rationale: The use of iron supplements is contraindicated in clients with hemochromatosis or hemolytic anemia.
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 nurse might administer epoetin alfa to a client with which type of anemia? Select all that apply.
- A. Anemia of chronic kidney disease
- B. Iron deficiency anemia
- C. Vitamin B12 deficiency anemia
- D. Anemia caused by cancer chemotherapy
- E. Anemia caused by zidovudine (AZT) therapy
Correct Answer: A,D,E
Rationale: Erythropoiesis-stimulating agents, like epoetin alfa, are used for anemia associated with the following: chronic kidney disease, cancer chemotherapy, zidovudine (AZT) therapy, and post-surgical replacement in place of allogeneic transfusions.