Mod 10- Drugs for Anemias Flashcards

1
Q

Which of the following instructions or patient education points is best associated with iron (ferrous sulfate)?

A

Keep out of Reach from Children
Explanation:
Since excessive amounts of iron is toxic, accidental or intentional overdose leads to poisoning. Iron preparations should be stored in childproof containers and kept out of reach of children.

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2
Q

Which of the following instructions or patient education points associated with iron (ferrous sulfate) improves absorption but may worsen GI side effects

A

Take Between Meals
Explanation:
Iron is best absorbed on an empty stomach. Certain dietary components may chelate iron and prevent it from being absorbed. Patients should thus be instructed not to take this medication with food. However, this will increase the incidence of GI upset. If patients cannot tolerate the increased GI side effects, they can be instructed to take iron with meals to increase medication adherence

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3
Q

Which of the following instructions or patient education points is best associated with iron (ferrous sulfate)?

A

Caution with GI Disorders
Explanation:
Since iron preparations cause GI effects, this medication may worsen symptoms associated with peptic ulcers, ulcerative colitis, and regional enteritis. Patients with these conditions should use this medication cautiously and avoid oral iron preparations.

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4
Q

Which of the following considerations is most important when administering iron (ferrous sulfate)?

A

Liquid can Stain Teeth
Explanation:
Liquid preparations of ferrous sulfate may stain teeth. Instruct the patient to dilute liquid iron preparations with juice or water, administer through a straw, and rinse the mouth after taking the medication.

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5
Q

Which of the following side effects is most likely associated with iron (ferrous sulfate) administration?

A

GI Distress
Explanation:
The body’s level of iron is regulated by intestinal absorption. Ferrous sulfate may cause GI distress such as heartburn (pyrosis), constipation, diarrhea, and bloating. These symptoms are dose-dependent and typically decrease with continued drug therapy. Patients experiencing constipation may benefit from a stool softener or laxative.

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6
Q

What mechanism of action or pharmacological action is best associated with iron (ferrous sulfate)?

A

Ferrous Salts
Explanation:
Iron is an essential component of hemoglobin, myoglobin, and certain enzymes. The bone marrow utilizes iron to make hemoglobin, the liver stores iron as ferritin, and the muscles incorporate iron to produce myoglobin. The body requires iron to transport oxygen throughout the body.

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7
Q

Which of the following instructions or patient education points is best associated with iron (ferrous sulfate)?

A

Avoid Antacids
Explanation:
Antacids decrease the body’s ability to absorb iron and should not be taken with ferrous sulfate.

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8
Q

Which of the following diseases or disorders is iron (ferrous sulfate) most likely indicated for?

A

Anemia
Explanation:
A deficiency in iron absorption leads to a decreased production of hemoglobin. Since hemoglobin is responsible for carrying oxygen throughout the body, the patient develops anemia and presents with fatigue and pallor. This drug also prevents iron deficiency associated with pregnancy or chronic blood loss. With iron deficiency anemia, the RBCs are microcytic and hypochromic.

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9
Q

Which of the following side effects is most likely associated with iron (ferrous sulfate) administration AND tends to worry patients upon incidence though harmless?

A

Dark Stools
Explanation:
Although ferrous sulfate may cause dark green or black-colored stools, inform the patient that this is a harmless side effect and not indicative of bleeding.

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10
Q

Which of the following side effects is most likely associated with iron (ferrous sulfate) administration AND diminishes with continued use?

A

Nausea and Vomiting
Explanation:
Administering ferrous sulfate increases the body’s amount of iron and subsequently affects the GI system’s ability to absorb the mineral. Symptoms of GI distress caused by iron preparations include nausea and vomiting. Inform the patient that continued therapy often leads to decreased symptoms.

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11
Q

Disorder involving too few red blood cells (RBCs) or ineffective RBCs that can alter the blood’s ability to carry oxygen

A

anemia

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12
Q

RBC that has lost its nucleus and entered circulation just recently, not yet fully matured

A

reticulocyte

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13
Q

Process of RBC production and life

A

erythropoiesis

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14
Q

Selective serotonin receptor blocker that causes a vascular constriction of cranial vessels; used to treat acute migraine attacks

A

triptan

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15
Q

Drug that causes a vascular constriction in the brain and the periphery; relieves or prevents migraine headaches but is associated with many adverse effects

A

ergot derivative

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16
Q

Drugs originally derived from opium that react with specific opioid receptors throughout the body

A

opioids

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17
Q

A client, diagnosed with chronic renal failure, has begun experiencing increasing shortness of breath. The nurse suspects that the client is experiencing symptoms associated with which resulting condition?

A

anemia

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18
Q

Which would be appropriate for a client who is receiving iron therapy?
Ensuring that the client consumes three large meals per day
Cautioning the client that stool may be dark or green
Encouraging the client to take the drug on an empty stomach
Advising the client to limit the amount of fiber in his diet

A

Cautioning the client that stool may be dark or green

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19
Q

A nursing instructor is teaching students about the myelin sheath of the central nervous system (CNS). The nurse knows that teaching has been effective when a student identifies which vitamin as necessary for the formation of the myelin sheath in the CNS?

A

Vitamin B12

20
Q

T/F: There is a risk of antibody production with the use of epoetin

A

True

21
Q

A 69-year-old client has been diagnosed with malignant melanoma. The care team has collaborated with the client and her family and agreed on a plan of care that includes administration of interferon alfa-2b. After administering interferon alfa-2b, the oncology nurse should anticipate that the client may develop which adverse effect?

A

Flulike symptoms

22
Q

A client is diagnosed with pernicious anemia. The nurse completes an assessment and finds severe pain on palpation at T12. The nurse would inform the health care provider because the nurse knows that which complication of pernicious anemia may be present?

A

Vitamin B12 deficiency causing pernicious anemia, progressing for more than three months, can cause degenerative lesions of the spinal cord.

23
Q

A patient has been receiving intramuscular injections of hydroxocobalamin as treatment for pernicious anemia. Which statement by the patient indicates that he understands the therapy?

A

“I will need these injections monthly for the rest of my life.”

24
Q

A client has been receiving regular doses of epoetin alfa for several weeks, and the home care nurse has been monitoring the client’s condition closely. When taking the client’s vital signs, the nurse should pay particular attention to what assessment datum?

A

blood pressure

25
Q

All hematopoietic and immune blood cells are derived from which cells in the bone marrow?

A

Stem cells

26
Q

A patient has been prescribed epoetin alfa. The nurse recognizes that this medication is indicated for treatment of anemia associated with which disease process?

A

Renal failure

27
Q

The nurse is caring for a client who is receiving epoetin alfa. What adjunct treatment will the nurse expect the health care provider to order for this client?

A

Iron supplement

28
Q

A patient who is HIV positive is receiving zidovudine 4,2000 mg/week and has an endogenous erythropoietin level of 350 mU/mL. What does the nurse anticipate will be administered for this patient?

A

Erythropoietin-

The normal range is 2.6 to 18.5 milliunits per milliliter (mU/mL).

29
Q

A client who was diagnosed with iron deficiency anemia is worried because she does not know why she was prescribed iron supplements. The nurse teaches the client about which action of oral iron administration?

A

Iron acts by elevating the serum iron concentration to replenish hemoglobin to treat anemia

30
Q

A male client is prescribed interferon. What is his probable diagnosis?
Hypertension
Viral hepatitis Sepsis
Bacteremia

A

Viral hepatitis

31
Q

What would be the priority nursing diagnosis for a patient who is prescribed epoetin alfa?

A

Impaired tissue oxygenation related to anemia

32
Q

A student nurse is caring for a client who is receiving a hematopoietic agent. To test the student’s understanding, the nursing instructor states that the drug could be administered by what route?

A

Subcutaneous or Intravenous

33
Q

The patient is being prescribed epoetin alfa for the treatment of anemia related to the renal failure. The patient also has a history of diabetes mellitus, uncontrolled hypertension, osteoarthritis, and hypothyroidism. Which of these conditions should the nurse bring to the physician’s attention prior to administering the medication?

A

Uncontrolled hypertension!!!

34
Q
A nurse is reviewing the chart of a patient with megaloblastic anemia. What might be used in the treatment of this patient? (Select all that apply.)
 Iron dextran Epogen 
Procrit 
Folic acid 
Vitamin B12
A

Folic acid

Vitamin B12

35
Q

A client, currently prescribed epoetin alfa, has recent blood work that reveals a hemoglobin level of 12.8 g/dL. What action does this assessment finding necessitate regarding the epoetin alfa?

A

temporarily withholding administration

36
Q

which anemia results from an inability to produce the intrinsic factor?

A

Pernicious anemia

37
Q

The pharmacology class learns that epoetin alfa is an immunosuppressant drug that is designed to have what expected outcome?

A

Increased RBC count

38
Q

A nurse has been assigned to a 43-year-old man who is to receive epoetin alfa therapy. The patient is HIV-positive and has anemia related to zidovudine therapy. The nurse will monitor:

A

Iron levels

39
Q

A client is receiving ferrous sulfate as treatment for iron deficiency anemia. After teaching the client, which statement indicates the need for additional teaching?

A

“I need to take an antacid with the pill to prevent an upset stomach.”

40
Q

T/F: The component of the red blood cell that is not recycled is bilirubin.

A

True

41
Q

A client prescribed epoetin alfa asks how the medication works. Which is the nurse’s best response?

A

“Increases the release of cells to increase the hemoglobin and hematocrit levels.”

42
Q

The average lifespan of a red blood cell (RBC) is approximately:

A

120 days

43
Q

A client diagnosed with iron deficiency anemia is learning about her prescribed iron supplement. Which additional information would the nurse include in the client’s teaching plan?

A

“If constipation or diarrhea become severe, call your primary care provider.”

44
Q

When administering iron injections, which method would the nurse use?

A

Z-track intramuscular

45
Q

Which process is cytokine-induced? Select all that apply.

A

cellular differentiation
antibody production
inflammation
tissue repair