Nokea
A nurse is caring for a client with hypertension who is prescribed epoetin alfa for anemia. Which of the following would the nurse include in the plan of care when administering this drug to the client?
- A. Report 10 mm Hg rise in systolic blood pressure to primary health care provider.
- B. Note the hematocrit value before each dose during therapy.
- C. Shake the drug well before it is administered to the client.
- D. Administer the drug once every 3 weeks through IV route.
Correct Answer: B
Rationale: When caring for a client who is prescribed epoetin alfa, the nurse should measure the hematocrit before each dose during the drug therapy. The nurse should monitor the blood pressure of a client with hypertension when he is receiving epoetin alfa and report any rise of 20 mm Hg or more in the systolic or diastolic pressure to the primary health care provider. The drug is given three times weekly IV or SC. 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.
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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.
A client is to receive darbepoetin alfa (Aranesp). When administering the drug, the nurse integrates knowledge of which of the following? Select all that apply.
- A. The drug is a glycoprotein.
- B. It is used to stimulate the production of erythrocytes.
- C. It helps stimulate differentiation of leukocytes.
- D. The drug promotes the maturation of megakaryocytes.
- E. It is used to stimulate thrombopoiesis
Correct Answer: A,B
Rationale: The following is true of the drug darbepoetin alfa (Aranesp): it is a glycoprotein, erythropoiesis-stimulating agent used to stimulate and regulate the production of erythrocytes (erythropoiesis).
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.
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 identifies a nursing diagnosis of Constipation for a client receiving iron supplements. Which of the following would be appropriate to promote resolution of this problem?
- A. Increase the intake of milk and dairy products.
- B. Consume a diet high in fiber.
- C. Take antacids after consuming meals.
- D. Perform vigorous exercises.
Correct Answer: B
Rationale: When caring for a client with constipation, the nurse should instruct the client to consume a high-fiber diet, increase fluid intake to 10 to 12 glasses of water daily, and increase activity. Increased activity can include exercise, however, the client does not need to engage in vigorous exercise. Increasing the intake of milk and dairy products or taking antacids after meals will not help reduce the constipation or the discomfort caused due to it.