Anemia and Hemopoietic Agents Self Study

Question 1

The most significant side effects of ferrous sulfate are:

Answer 1

GI disturbance

Nausea, vomiting, heartburn, constipation, diarrhea.

Question 2

. During the initial therapy of the ferrous sulfate, the nurse teaches the patient to take the ferrous sulfate between meals or with food to decrease GI side effects?

Answer 2

With food

Question 3

When Luellen Rogers returns to the clinic in 3 months, the nurse correctly instructs the patient to change the administration to ________ (between meals or with food) to increase the absorption of the medication.

Answer 3

between meals

Question 4

Luellen calls the clinic because she is concerned that there is now blood in her stool. She reports the stool is dark green/black in color. How should the nurse respond to this patient concern?
(Ferrous Sulfate supplement)

Answer 4

Dark green/black stool is a harmless side effect of oral iron supplements and not indicative of bleeding.

Question 5

Leuellen doesn’t like to swallow pills and would like to try the liquid iron preparations. What instruction should the nurse give the patient, particular to this formation?
(Ferrus sulfate supplement)

Answer 5

Dilute the liquid formulation gin juice or water, drink with a straw, and rinse mouth with water to prevent staining of the teeth.

Question 6

The most serious adverse effect of giving iron dextran intravenously is _________.

Answer 6

anaphylaxis

Question 7

IV administration of iron dextran requires what additional resources to be on hand?

Answer 7

Injectable epinephrine and resuscitation supplies

Question 8

IM administration of iron dextran can cause pain, discoloration, and tumors at the site.
What administration technique should be used to administer Iron dextran IM?

Answer 8

Injected deep in the buttock using the Z-track technique

Question 9

What is typically given prior to the full therapeutic dose regardless of IM or IV administration of iron dextran?

Answer 9

Test dose

Question 10

The presence of Vitamin B12 helps to catalyze the conversion of ____ ___ to its active form.

Answer 10

folic acid

Question 11

In what forms can vitamin B12 be administered?

Answer 11

Oral, IM, SQ, intranasal

NOT IV

Question 12

All patients with vitamin B12 deficiency may benefit from oral vitamin B12.
(True or False)

Answer 12

False, patients with severe neurological symptoms should be treated with SQ or IM B12.

Question 13

Patients taking the intranasal formulation should receive instruction to avoid ___ _____ for _ ____ before or after administering the drug.

Answer 13

Hot Foods, 1 hour

Question 14

A patient with severe neurological deficiency from vitamin B12 deficiency should be given __ __ __ form of the drug.

Answer 14

IM or SQ

Question 15

Patients with pernicious anemia (intrinsic factor deficiency) will have to continue treatment for how long?

Answer 15

Life long treatment

Question 16

Which of the following individuals are typical for folic acid or folinic acid therapy? Select all that apply

• women thinking about becoming pregnant
• women who are pregnant
• alcoholics
• patients receiving cancer chemotherapy
• child with poor nutrition
• patient with disease of the small intestine

Answer 16

• women thinking about becoming pregnant
• women who are pregnant
• alcoholics
• child with poor nutrition
• patient with disease of the small intestine

Question 17

A caregiver presents to the emergency room with an Alzheimer’s patient who has accidentally taken a whole bottle of folic acid. What treatment does the nurse expect?

Answer 17

Says massive dosages (15 mg) have been taken with no ill effects as long as it’s not long term.
Long-term high doses of folic acid can lead to colon and prostate cancer.

Question 18

The production of what kind of blood cell is stimulated by erythropoietin?

Answer 18

Red blood cells

Erythropoietic growth factor.

Question 19

The production of what kind of blood cell is stimulated by granulocyte colony-stimulating factor (GCSF)?

Answer 19

White blood cells

Leukopoietic growth factor.

Question 20

The production of what kind of blood cell is stimulated by Oprelvekin (interleuken-11)?

Answer 20

Platelets

Thrombopoietic growth factor.

Question 21

True or False: All hematopoietic growth factors come in a SQ formulation.

Answer 21

True

Question 22

What are four indications for receiving erythropoietin?

Answer 22

Anemia of chronic renal failure
Chemotherapy-induced Anemia (nonmyeloid malignancies only and when the treatment goal is not curative)
HIV-infected Patients Taking Zidovudine (AZT)
Anemia in Patients Facing Surgery

Question 23

The most significant side effect of epoetin alfa (Erythropoietin) is _____________.

Answer 23

hypertension

Question 24

Patients receiving epoetin alfa (Erythropoietin) should have CBC measured twice weekly. When the hemoglobin rises above __gm/dL, there is an increased risk of serious cardiovascular events and death.

Answer 24

11gm/dL

Question 25

Epoetin alfa (Erythropoietin) and filgrastim (GCSF) can be administered __ __ __.

Answer 25

IV or SQ

Question 26

Filgrastim (GCSF) is used in cancer patients with low ________ counts to decrease the risk of _______.

Answer 26

neutrophil, infection

Question 27

The most common side effect of filgrastim (GCSF) is ____ ____, which can usually be treated with acetaminophen.

Answer 27

Bone pain

Question 28

Oprelvekin (Interleukin-11) starts to work in ___ days after the first injection and is more effective in patients with less myelosuppression.

Answer 28

5-9 days

Question 29

The (4) major adverse effects of oprelvekin (Interleukin-11) include:

Answer 29

a) Fluid retention
b) Cardiac dysrhythmias
c) Severe allergic reaction
d) conjunctiva infection

Question 30

Oprelvekin (Interleukin-11) is administered by which route?

Answer 30

SQ

Question 31

True or False: All hematopoietic agents are made by recombinant DNA technology and therefore tend to be expensive medications.

Answer 31

True