Nokea
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.
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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.
The nurse is administering folic acid to a patient with a new diagnosis of anemia. Which statement about treatment with folic acid is true?
- A. Folic acid is used to treat any type of anemia.
- B. Folic acid is used to treat iron-deficiency anemia.
- C. Folic acid is used to treat pernicious anemia.
- D. The specific cause of the anemia needs to be determined before treatment.
Correct Answer: D
Rationale: Folic acid should not be used to treat anemias until the underlying cause and type of anemia have been identified. Administering folic acid to a patient with pernicious anemia may correct the hematologic changes of anemia, but the symptoms of pernicious anemia (which is due to a vitamin B12 deficiency, not a folic acid deficiency) may be deceptively masked.
A patient will be receiving epoetin alfa (Epogen) 8000 units IV three times a week. The medication is available in a vial that contains 10,000 units/mL. How many milliliters will the nurse draw up for this dose?
Correct Answer: 0.8 mL
Rationale: Calculate volume: 10,000 units:1 mL::8000 units:x mL. (10,000 ?? x) = (1 ?? 8000); 10,000x = 8000; x = 0.8 mL.
A patient will be taking oral iron supplements at home. The nurse will include which statements in the teaching plan for this patient? (Select all that apply.)
- A. Take the iron tablets with meals to reduce GI upset.
- B. Take the iron tablets on an empty stomach 1 hour before meals.
- C. Take the iron tablets with an antacid to prevent heartburn.
- D. Drink 8 ounces of milk with each iron dose.
- E. Taking iron supplements with orange juice enhances iron absorption.
- F. Stools may become loose and light in color.
- G. Stools may become black and tarry.
Correct Answer: A,E,G
Rationale: Iron tablets need to be taken with meals to reduce gastrointestinal distress, but antacids and milk interfere with absorption. Orange juice enhances the absorption of iron. Stools may become black and tarry in patients who are on iron supplements. Tablets need to be taken whole, not crushed, and the patient needs to be encouraged to eat foods high in iron.
A patient has been receiving epoetin alfa for severe iron-deficiency anemia. Today, the provider changed the order to darbepoetin. The patient questions the nurse, 'What is the difference in these drugs?' Which response by the nurse is correct?
- A. There is no difference in these two drugs.
- B. Aranesp works faster than Epogen to raise your red blood cell count.
- C. Aranesp is given by mouth, so you will not need to have injections.
- D. Aranesp is a longer-acting form, so you will receive fewer injections.
Correct Answer: D
Rationale: Darbepoetin (Aranesp) is longer-acting than epoetin alfa (Epogen); therefore, fewer injections are required.