Erythropoiesis-Stimulating Agents

Question 1

MECHANISM OF ACTION

Answer 1

Acts like the natural glycoprotein erythropoietin to stimulate the production of RBC’s in the bone marrow
(tells our bone marrow to make more RBC’s)

Question 2

MEDICATIONS

Answer 2

Epoetin Alfa is given 3 x week (IV or subcutaneously)

Darbopoetin Alfa

Question 3

What type of patient uses Epoetin Alfa?

Answer 3

A patient with renal failure and AIDS.

Also It decreases the need for a blood transfusion in surgical patients.

Question 4

What type of patient uses

Darbopoetin Alfa?

Answer 4

This med is used to treat anemia in patients with chronic renal failure including dialysis patients

Question 5

Indication (use)

Answer 5

treats anemia associated with chronic renal failure to reduce the need for allogenic blood transfusions in surgical patients

Question 6

CONTRAINDICATIONS

Answer 6

-uncontrolled hypertension
-allergy to mammalian cell- derived
-allergy to human albumin
(I believe this means allergic to human blood as in a blood transfusion)

Question 7

Drug -Drug Interaction

Answer 7

Should not be mixed in solutions with other drugs (in syringe)

Question 8

Cautions

Answer 8

DO NOT take if you have NORMAL RENAL FUNCTION (because normal functioning kidneys may think they no longer have to work)

DO NOT take if you have RENAL DYSFUNCTION

pregnant/lactating

Question 9

Adverse Effects

Answer 9

Headache
Fatigue
Asthenia
Dizziness
Seizure
Nausea, Vomiting, Diarrhea
Hypertension (important one)
Edema
possible chest pain

Question 10

Nursing Process- ASSESSMENT

Answer 10

Check if patient is anemic, has hypertension, has abnormal renal function. Check if patient has cancer and is receiving drugs to increase hematocrit.

Assess neuro, cardiovascular status
check BP, respirations

labs: renal function, CBC for the hematocrit, Iron studies, electrolytes

Question 11

NURSING DIAGNOSIS

Answer 11

Nausea related to adverse GI effects

Diarrhea related to GI effects

Risk for injury related to CNS effects

Risk for imbalanced fluid volume related to CV effects

Question 12

IMPLEMENTATION

Answer 12

*Confirm the chronic, renal nature of the patient’s anemia before
administering the drug
*Give epoetin alfa three times per week, either IV or subcutaneously
*Do not mix with any other drug solution
*Monitor lines for clotting (IV lines, dialysis catheter)
*Ensure that prescribed laboratory testing, such as hematocrit levels, is
completed before drug administration
*Evaluate iron stores before and periodically during therapy
*Monitor blood pressure due to risk for hypertension
*Maintain seizure precautions on standby

Question 13

IMPLEMENTATION/PATIENT TEACHING

Answer 13

Teach patient how to administer SQ
Review needle safety
Mark days on a calendar of when to administer
Review cardio effects with patient