Nokea
A nurse is giving instructions to a patient who will be receiving oral iron supplements. Which instructions will be included in the teaching plan?
- A. Take the iron tablets with milk or antacids.
- B. Crush the pills as needed to help with swallowing.
- C. Take the iron tablets with meals if gastrointestinal distress occurs.
- D. If black tarry stools occur, report it to the doctor immediately.
Correct Answer: C
Rationale: Although taking iron tablets with food may decrease absorption, doing so helps to reduce gastrointestinal distress. Antacids and milk may cause decreased iron absorption; iron tablets must be taken whole and not crushed. Black, tarry stools are expected adverse effects of oral iron supplements.
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During therapy with the hematopoietic drug epoetin alfa, the nurse instructs the patient about adverse effects that may occur, such as
- A. Anxiety
- B. Drowsiness
- C. Hypertension
- D. Constipation
Correct Answer: C
Rationale: Hypertension is an adverse effect of hematopoietic drugs, along with headache, fever, pruritus, rash, nausea, vomiting, arthralgia, cough, and injection site reaction.
A cancer patient is receiving drug therapy with epoetin alfa. The nurse knows that the medication must be stopped if which laboratory result is noted?
- A. White blood cell count of 550 cells/mm?³
- B. Hemoglobin level of 12 g/dL
- C. Potassium level of 4.2 mEq/L
- D. Glucose level of 78 mg/dL
Correct Answer: B
Rationale: If epoetin is continued when hemoglobin levels are above 11 g/dL, patients may experience serious adverse events, including heart attack, stroke, and death. Caution must be used when hemoglobin levels are above 10 g/dL for cancer patients and 11 g/dL for renal patients.
The nurse is administering intravenous iron dextran for the first time to a patient with anemia. After giving a test dose, how long will the nurse wait before administering the remaining portion of the dose?
- A. 30 minutes
- B. 1 hour
- C. 6 hours
- D. 24 hours
Correct Answer: B
Rationale: Although anaphylactic reactions usually occur within a few moments after the test dose, it is recommended that a period of at least 1 hour elapse before the remaining portion of the initial dose is given.
An oral iron supplement is prescribed for a patient. The nurse would question this order if the patient's medical history includes which condition?
- A. Decreased hemoglobin
- B. Hemolytic anemia
- C. Weakness
- D. Concurrent therapy with erythropoietics
Correct Answer: B
Rationale: Iron supplements are contraindicated in anemias that are not caused by iron-deficiency, such as hemolytic anemia. Decreased hemoglobin and weakness are related to iron-deficiency anemia. Iron supplements are given with erythropoietic drugs to aid in the production of red blood cells.
A patient with end-stage renal failure has been admitted to the hospital for severe anemia. The patient is refusing blood transfusions. The nurse anticipates drug therapy with which drug to stimulate the production of red blood cells?
- A. Folic acid
- B. Cyanocobalamin
- C. Epoetin alfa
- D. Filgrastim
Correct Answer: C
Rationale: Epoetin alfa is a colony-stimulating factor that is responsible for erythropoiesis, or formation of red blood cells.