Pharmacological and Parenteral Therapies

Question 1

Renal replacement therapy (RRT)

Answer 1

• refers to life-supporting treatments provided to clients with renal failure.
• replaces the non-hormonal renal function in clients with renal failure.
• Renal replacement therapy options include intermittent hemodialysis, continuous hemodialysis, and peritoneal dialysis.

Question 2

Peritoneal dialysis

Answer 2

• Allows clients more autonomy, as the procedure may often be performed from the comfort of the client’s home following the appropriate client training
• During peritoneal dialysis, the peritoneum is used as the dialyzing membrane, and the dialysate is infused through a catheter tunneled into the peritoneum.
• Maintaining a sterile technique is essential during peritoneal dialysis.
• In general, dialysate is instilled through a catheter into the peritoneal space, is left to dwell, and then drained.
• In the double-bag technique, the patient drains the fluid instilled in the abdomen in one bag and then infuses fluid from the other bag into the peritoneal cavity.
• Peritoneal dialysis may be done manually or using an automated device.

Question 3

Most important and common complications of peritoneal dialysis

Answer 3

Peritonitis and Catheter tunnel exit-site infection

Question 4

Formula for flow rate and drops per minute

Answer 4

Total volume x drop factor / time in minutes

Question 5

Doxycycline

Answer 5

A tetracycline antibiotic that fights bacteria in the body. It treats many different bacterial infections, such as acne, sexually transmitted infections, and pneumonia

• This antibiotic should not be administered concurrently with products rich in calcium because it will weaken the effects of the antibiotic
• The client should avoid exposure to tanning beds and direct sunlight, use sunscreen, and/or wear protective clothing because of drug-related photosensitivity
• Photosensitive effects may be noticed within a few minutes to hours after taking the drug and may last up to several days after the drug has been discontinued

Question 6

Enoxaparin

Answer 6

• A low-molecular-weight heparin (LMWH)
• Bleeding is the major risk associated with the use of enoxaparin
• Contraindicated in clients with any active clinically significant bleeding, including gastrointestinal bleeding
• Although clients taking enoxaparin do not require aPTT monitoring, periodic assessment of platelets should be performed as a small percentage of clients experience heparin-induced thrombocytopenia.

Question 7

Iron sucrose

Answer 7

• Is a form of iron administered intravenously to clients with iron deficiency
• Ferrous sulfate is the most common form of iron supplement administered orally
• While there is controversy about whether oral ingestion of iron supplements causes false-positive fecal occult blood tests (FOBT), intravenous iron certainly does not cause false-positive FOBT.

Question 8

Sucralfate

Answer 8

• a gastric mucosa protectant used to treat and prevent the recurrence of duodenal ulcers
• does not have the tendency to cause or make gastrointestinal bleeding

Question 9

Hydroxyurea

Answer 9

indicated for the treatment of certain cancers and sickle cell anemia

Question 10

Manifestations of a Hemolytic Reaction

Answer 10

• low-back pain
• chest pain
• tachycardia
• hypotension, and
• a feeling of impending doom.

✓ If a hemolytic reaction is assessed, the nurse should immediately discontinue the transfusion and save the tubing and unit of blood for further analysis.

✓ Immediate client care involves spiking a new bag of isotonic saline (with new tubing) and keeping the intravenous catheter patent. The nurse should notify the PHCP and blood bank.

Question 11

Hemolytic Blood Transfusion

Answer 11

• May be fatal if not caught promptly.
• The primary cause of this reaction is the misidentification of the client and the blood product.