Lilly Pharm Ch 55 Anemia Drugs Flashcards
A patient is to receive dextran (Dexiron) injections. What should the nurse use to administer this medication?
a. IV injection mixed with 5% dextrose
b. IM injection in the upper arm
c. IM injection using the Z-track method
d. Subcutaneous injection with a half-inch, 29g needle.
c. IM injection using the Z-track method.
What is the Purpose of the Z-Track Method?
The Z-track method is a specialized intramuscular (IM) injection technique used to prevent medication from leaking back into the subcutaneous tissue. It involves pulling the skin laterally before injection, which creates a zig-zag pathway when the needle is removed.
Why Use the Z-Track Method?
1. Prevents Medication Leakage
• Some IM medications, such as iron dextran (Dexiron), can stain the skin or cause tissue irritation if they leak into the subcutaneous layer.
• The Z-track technique seals the medication in the muscle, preventing it from tracking back along the needle path.
2. Reduces Skin and Tissue Irritation
• Certain medications (e.g., iron, antibiotics, some hormones) can be caustic to the subcutaneous tissue, causing pain, inflammation, or discoloration.
• By keeping the medication in the muscle, the irritation is minimized.
3. Improves Medication Absorption
• IM injections are designed to release medication slowly into the bloodstream.
• Leakage into the subcutaneous tissue may alter the absorption rate, reducing drug effectiveness.
4. Reduces Pain and Discomfort
• Sealing the medication in the muscle reduces the chance of burning or stinging at the injection site.
• The technique also minimizes bruising.
Steps of the Z-Track Method
1. Pull the skin laterally (2-3 cm) using the non-dominant hand.
2. Insert the needle at a 90-degree angle into the muscle.
3. Aspirate (if required) to check for blood return.
4. Inject the medication slowly (over 5-10 seconds).
5. Wait 10 seconds before removing the needle.
6. Withdraw the needle quickly and release the skin immediately to “seal” the medication inside the muscle.
Common Medications That Require Z-Track
• Iron dextran (Dexiron)
• Hydroxyzine
• Chlorpromazine
• Certain antibiotics (e.g., ceftriaxone, some penicillins)
• Testosterone injections
Would you like a visual guide to make it easier to understand?
A patient is prescribed oral iron supplementation. What should the nurse tell the patient to do while on this treatment.
a. Take the iron tablets with milk or antacids.
b. crush the pulls as needed to help swallowing.
c. Avoid reclining positions for up to 30 minutes after taking the drug.
d. You do not need to eat foods that are high in iron, such as meat, dark green leafy vegetables, and dried beans.
c. Avoid reclining positions for up to 30 minutes after taking the drug.
In order to prevent esophageal irritation or corrosion, patients on an iron supplement should avoid reclining positions for 15-30 minutes after taking the drug. Antacids and milk may cause decreased iron absorption; iron tablets should be taken whole and not crushed; and clients should continue to eat foods high in iron.
What my occur as a result of therapy with iron preparations?
a. palpitations
b. dizziness and syncope
c. black and red tarry stools
d. yellow discolouration of the urine
c. black and red tarry stools
A patient has been taking iron supplements for anemia for 4 weeks. Which therapeutic response should the patient be taught to watch for?
a. decreased weight
b. absence of fatigue
c. decreased palpitations
d. decreased visual disturbances
b. absence of fatigue
Before administering iron supplements, the nurse should assess for which contraindications?
a. poor nutrition
b. hemolytic anemia
c. weakness and fatigue
d. decreased hemoglobin
b. hemolytic anemia
When ferrous fumarate (Palafer) is given to infants, what is the onset of action time period?
a. 10-12 hours
b. 24 - 48 hours
c. 3 to 10 days
d. 14 to 21 days
c. 3-10 days
The nurse is teaching a patient about he oral administration of iron preparations. What will increase the absorption of iron?
a. milk
b. yogurt
c. antacids
d. ascorbic acid
d. ascorbic acid
enhances the absorption of oral iron. antacids, milk, and yogurt may interfere.
A patient is taking a liquid form of an iron product. What should the nurse tell the patient to do when taking this product?
a. follow the dose with milk.
b. take the medication through a plastic straw.
c. mix the dose with juice and sip slowly.
d. drink the medication undiluted from a measured medicine cup.
b. take the medication through a plastic straw.
Helps to decrease discolouration of tooth enamel.
A woman is planning to become pregnant in the next year. To reduce the risk for fetal neural tube defects, she should ensure that she receives adequate levels of what?
a. Vitamin B12
b. Vitamin C
c. Iron
d. Folic acid
d. folic acid
The nurse is administering medications to a patient with a new diagnosis of anemia. Which is a true statement about treatment with folic acid?
a. Folic acid is used to treat any type of anemia
b. The cause of the anemia should be determined before treatment with folic acid.
c. Folic acid is used to treat pernicious anemia
d. Folic acid is used to treat iron deficiency anemia.
b. The cause of the anemia should be determined before treatment with folic acid.
It shouldn’t be given without finding the underlying cause because administering folic acid to a patient with pernicious anemia will correct the hematological changes of anemia, but the symptoms of pernicious anemia (which is instead caused by a b12 deficiency) may be deceptively masked.
