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The nurse is reviewing the medical record of a patient before giving a new order for iron sucrose. Which statement regarding the administration of iron sucrose is correct?
- A. The medication is given with food to reduce gastric distress.
- B. Iron sucrose is contraindicated if the patient has renal disease.
- C. A test dose will be administered before the full dose is given.
- D. The nurse will monitor the patient for hypotension during the infusion.
Correct Answer: D
Rationale: Iron sucrose (Venofer) is an injectable iron product indicated for the treatment of iron-deficiency anemia in patients with chronic renal disease. It is also used for patients without kidney disease. Its risk of precipitating anaphylaxis is much less than that of iron dextran, and a test dose is not required. Hypotension is the most common adverse effect and appears to be related to infusion rate.
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The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects?
- A. Palpitations
- B. Drowsiness and dizziness
- C. Black, tarry stools
- D. Orange-red discoloration of the urine
Correct Answer: C
Rationale: Black, tarry stools and other gastrointestinal disturbances may occur with the administration of iron preparations.
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.
The nurse is administering liquid oral iron supplements. Which intervention is appropriate when administering this medication?
- A. Have the patient take the liquid iron with milk.
- B. Instruct the patient to take the medication through a plastic straw.
- C. Have the patient sip the medication slowly.
- D. Have the patient drink the medication, undiluted, from the unit-dose cup.
Correct Answer: B
Rationale: Liquid oral forms of iron need to be taken through a plastic straw to avoid discoloration of tooth enamel. Milk may decrease absorption.
A patient is to receive iron dextran injections. Which technique is appropriate when the nurse is administering this medication?
- A. Intravenous administration mixed with 5% dextrose
- B. Intramuscular injection in the upper arm
- C. Intramuscular injection using the Z-track method
- D. Subcutaneous injection into the abdomen
Correct Answer: C
Rationale: Intramuscular iron is given using the Z-track method deep into a large muscle mass. If given intravenously, it is given with normal saline, not 5% dextrose.
A 2-year-old child will be receiving ferrous sulfate oral drops (Fer-Iron) 5 mg/kg/day in three divided doses. The child weighs 30 pounds. Identify how many milligrams the nurse will administer per dose. (Record answer using one decimal place.)
Correct Answer: 22.7 mg
Rationale: Convert pounds to kilograms: 30 ?· 2.2 = 13.6 kg. Calculate the total dose per day: 5 mg/kg/day ?? 13.6 kg = 68 mg/day. Divide into 3 doses: 68 mg/day ?· 3 doses/day = 22.67, rounded to 22.7 mg/dose.