Nokea
A nurse is administering darbepoetin alfa to a client. The nurse checks the client's hemoglobin level carefully during the administration based on the understanding that polycythemia can occur, leading to which of the following? Select all that apply.
- A. Increased mortality
- B. Tumor progression
- C. Severe hypotension
- D. Thromboembolic events
- E. Cardiovascular events
Correct Answer: A,B,D,E
Rationale: Polycythemia is an overload of erythrocytes that can result in increased mortality, serious cardiovascular and thromboembolic events, and possible tumor progression in clients with cancer.
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A nurse is providing care to a client experiencing hematologic failure. The nurse understands that this can include which of the following? Select all that apply.
- A. Anemia
- B. Bleeding
- C. Hypertension
- D. Infection
- E. Hypoglycemia
Correct Answer: A,B,D
Rationale: Hematologic failure results when inadequate numbers of blood cells are produced, leading to decreased oxygen transportation, blood coagulation, or inability for the body to prevent the invasion of microorganisms, which can lead to anemia, bleeding, and infection.
A client is prescribed vitamin B12 for his pernicious anemia following gastric bypass surgery. The nurse would be alert for which of the following as a possible adverse reaction?
- A. Urticaria
- B. Dyspnea
- C. Pulmonary edema
- D. Joint pain
Correct Answer: C
Rationale: The nurse needs to closely monitor the client for pulmonary edema, an adverse reaction to vitamin B12. The other adverse reactions to the administration of vitamin B12 include increased RBC production, acne, peripheral vascular thrombosis, heart failure, mild diarrhea, and itching. Urticaria and dyspnea are caused when iron is administered parenterally. Joint pain is an adverse reaction to epoetin alfa.
A client is prescribed sargramostim (Leukine). Before administering the drug, the nurse would inform the client that which of the following may occur with this drug? Select all that apply.
- A. Bone pain
- B. Anemia
- C. Infection
- D. Nausea
- E. Rash
Correct Answer: A,D,E
Rationale: Headache, bone pain, nausea, vomiting, diarrhea, alopecia, and rash are adverse reactions the nurse should inform the client about prior to the administration of sargramostim (Leukine).
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.
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.