Nokea
A client with megaloblastic anemia is prescribed leucovorin. The nurse would identify which of the following as a contraindication for this drug?
- A. Pernicious anemia
- B. Hemochromatosis
- C. Uncontrolled hypertension
- D. Hypersensitivity to human albumin
Correct Answer: A
Rationale: Leucovorin is contraindicated in clients with pernicious anemia or other anemias in which vitamin B12 is deficient. Leucovorin is not contraindicated in clients with hemochromatosis, uncontrolled hypertension, and hypersensitivity to human albumin. Epoetin alfa is contraindicated in clients with uncontrolled hypertension and hypersensitivity to human albumin. Iron compounds are contraindicated in clients with hemochromatosis or hemolytic anemia.
You may also like to solve these questions
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 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 with iron deficiency anemia is prescribed iron supplements. After administering the drug, the nurse would assess the client for which of the following as a possible adverse reaction related to gastrointestinal function?
- A. Headache
- B. Darker stools
- C. Soreness
- D. Backache
Correct Answer: B
Rationale: The nurse needs to closely monitor the client for darker stools as an adverse gastrointestinal reaction to iron supplements. Headache and backache are the generalized system reactions to iron supplements. Soreness is a generalized system reaction to the administration of iron when given though the parenteral route.
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 prescribed vitamin B12 for vitamin B12 deficiency anemia. After teaching the client about the drug, the nurse determines that the teaching was successful when the client states that which of the following can decrease the absorption of oral vitamin B12? Select all that apply.
- A. Alcohol
- B. Calcium
- C. Neomycin
- D. Colchicine
- E. Phenytoin
Correct Answer: A,C,D
Rationale: Alcohol, neomycin, and colchicine may decrease the absorption of oral vitamin B12.