52: Epogen
A client who is HIV positive is receiving epoetin (Epogen) for management of anemia secondary to zidovudine (AZT) therapy. Which laboratory
... [Show More] finding is most important for the nurse to report to the healthcare provider?
Hematocrit (HCT) of 58%
the nurse reviews the blood reports of a patient who is receiving epoetin alfa (Epogen) and finds that the medication is effective. Which finding in the blood lab report enables the nurse to reach this conclusion?
Hemoglobin levels of 15 g/dL
A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?
A. Reports of increased energy levels and decreased fatigue
B. Takes concurrent iron therapy without adverse effects
C. Food diary shows increased consumption of iron-rich foods
D. Hemoglobin level increased to 12 grams/dL (120 mmol/L)
Answer: D. Hemoglobin level increased to 12 grams/dL (120 mmol/ L)
51: low neutrophil/neutropenic precautions
After receiving five doses of filgrastim the nurse notes that the client’s white blood cell count has increased from 2500/mm (2.5* 10/LSI) to 5,000/mm(5* 10/LSI).
What action should the nurse implement?
Answer: B. Implement neutropenic precautions
50: Calcitonin
● hypocalcemia = tetany (911)
tx: Calcium gluconate// calcium chloride
*** calcium glutinate @ bedside for thyroidectomy — high risk of hypocalcemia ***
● hypercalcemia
tx avoid vit D in large amounts, calcitonin
*** if patient has low calcium levels/HYPOcalcemia — HOLD CALCITONIN (lowers the levels) ***
49: Lithium
● Ibuprofen causes increased toxicity
● ASPIRIN = SAFE
● Monitor sodium levels — HYPOnatremia causes increased toxicity, sudden
HYPERnatremia causes decrease lithium levels
● Diuretics contraindicated — decrease the sodium levels, causing toxicity
● ***when levels are too HIGH, drink 3L water***
A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate. Which instruction should the nurse provide to the client?
a) Notify healthcare provider prior to dental procedure
b) Avoid consuming all foods that contain iodine.
c) Monitor blood glucose levels daily.
d) Eliminate of nonsteriodal anti-inflammatory drugs (NSAIDSs).
d) Eliminate of nonsteriodal anti-inflammatory drugs (NSAIDSs).
ANS: D
48: lactulose
A client with Encephalopathy is receiving lactulose. Which assessment provides the nurse best information to improve in drug.
a) stool color
b) Serum electrolytes and ammonia
c) Fingerstick glucose
d) Serum hepatic enzymes ANS: B
** decreased ammonia levels = improved mental status — shows effectiveness of lactulose ** [Show Less]