Nokea
A patient with poorly controlled diabetes has developed end-stage renal failure and consequent anemia. When reviewing this patient's treatment plan, the nurse should anticipate the use of what drug?
- A. Magnesium sulfate
- B. Epoetin alfa
- C. Low-molecular weight heparin
- D. Vitamin K
Correct Answer: B
Rationale: The availability of recombinant erythropoietin (epoetin alfa [Epogen, Procrit], darbepoetin alfa [Aranesp]) has dramatically altered the management of anemia in end-stage renal disease. Heparin, vitamin K, and magnesium are not indicated in the treatment of renal failure or the consequent anemia.
You may also like to solve these questions
A patient is admitted to the diagnosis of pernicious anemia. The nurse should prepare to administer which of the following medications?
- A. Folic acid
- B. Vitamin B12
- C. Lactulose
- D. Magnesium sulfate
Correct Answer: B
Rationale: Pernicious anemia is characterized by vitamin B12 deficiency. Magnesium sulfate, lactulose, and folic acid do not address the pathology of this type of anemia.
A patient's absolute neutrophil count (ANC) is 440/mm3. But the nurse's assessment reveals no apparent signs or symptoms of infection. What action should the nurse prioritize when providing care for this patient?
- A. Meticulous hand hygiene
- B. Timely administration of antibiotics
- C. Provision of a nutrient-dense diet
- D. Maintaining a sterile care environment
Correct Answer: A
Rationale: Providing care for a patient with neutropenia requires that the nurse adhere closely to standard precautions and infection control procedures. Hand hygiene is central to such efforts. Prophylactic antibiotics are rarely used and it is not possible to provide a sterile environment for care. Nutrition is highly beneficial, but hand hygiene is the central aspect of care.
A nurse is providing discharge education to a patient who has recently been diagnosed with a bleeding disorder. What topic should the nurse prioritize when teaching this patient?
- A. Avoiding buses, subways, and other crowded, public sites
- B. Avoiding activities that carry a risk for injury
- C. Keeping immunizations current
- D. Avoiding foods high in vitamin K
Correct Answer: B
Rationale: Patients with bleeding disorders need to understand the importance of avoiding activities that increase the risk of bleeding, such as contact sports. Immunizations involve injections and may be contraindicated for some patients. Patients with bleeding disorders do not need to normally avoid crowds. Foods high in vitamin K may be beneficial, not detrimental.
A patient is being treated on the medical unit for a sickle cell crisis. The nurse's most recent assessment reveals an oral temperature of 100.5°F and a new onset of fine crackles on lung auscultation. What is the nurse's most appropriate action?
- A. Apply supplementary oxygen by nasal cannula.
- B. Administer bronchodilators by nebulizer.
- C. Liaise with the respiratory therapist and consider high-flow oxygen.
- D. Inform the primary care provider that the patient may have an infection.
Correct Answer: D
Rationale: Patients with sickle cell disease are highly susceptible to infection; thus any early signs of infection should be reported promptly. There is no evidence of respiratory distress, so oxygen therapy and bronchodilators are not indicated.
A patient with renal failure has decreased erythropoietin production. Upon analysis of the patients complete blood count, the nurse will expect which of the following results?
- A. An increased hemoglobin and decreased hematocrit
- B. A decreased hemoglobin and hematocrit
- C. A decreased mean corpuscular volume (MCV) and red cell distribution width (RDW)
- D. An increased MCV and RDW
Correct Answer: B
Rationale: The decreased production of erythropoietin will result in a decreased hemoglobin and hematocrit. The patient will have normal MCV and RDW because the erythrocytes are normal in appearance.