ATI Pharmacology The Hematologic System Test Flashcards

Reticulocyte count

- A reticulocyte count measures the amount of immature RBCs. Folic acid, also called folate, is essential for erythropoiesis. Patients who have a folic acid deficiency require a baseline reticulocyte count, as well as a serum folate, Hgb, Hct, and RBC count and periodic monitoring during folic acid therapy to determine effectiveness.

Clarify the prescription with the provider

- Leukocytosis can occur with filgrastim therapy. It is essential to monitor CBC twice per week and reduce the dosage or stop therapy for a WBC count above 10,000/mm³​. The health care professional should notify the provider of the patient’s current WBC count and clarify the prescription prior to administration.

Administer a test dose is correct. Iron dextran can cause a hypersensitivity reaction. It is essential to administer a test dose to determine hypersensitivity prior to giving the full dosage initially and to allow 1 hr for identifying any adverse reactions.

Monitor blood pressure is correct. Iron dextran can cause hypotension and hypersensitivity reactions, so it is important to monitor blood pressure.

Have epinephrine available is correct. Iron dextran can cause a hypersensitivity reaction. It is essential to have epinephrine and resuscitation equipment available and to monitor for skin rash, fever, and chills.

Premedicate with atropine is incorrect . Iron dextran is more likely to cause tachycardia than bradycardia. Therefore, it is unnecessary to premedicate with atropine.

Use the Z-track technique is correct. Health care professionals giving the drug IM should use the Z-track technique to make sure to deposit it deep into the buttocks. Superficial injection can cause abscesses and brown discoloration of the skin.

Enlarged spleen

-With long-term use, filgrastim, a leukopoietic growth factor, can cause an enlarged spleen. Health care professionals should tell patients taking the drug to monitor and report abdominal pain or fullness.

Ibuprofen (Motrin)

-NSAIDs, such as ibuprofen and especially aspirin, can increase the risk of bleeding for patients taking warfarin, an anticoagulant.

Creutzfeldt-Jakob disease

-Recombinant factor IX is safer than the plasma-derived formulation because of the risk of Creutzfeldt-Jakob disease, a prion-transmitted infection, from human sources. Plasma-derived products also carry a minimal risk of acquiring hepatitis A and parvovirus B19.

Vitamin B₁₂

- Patients who have megaloblastic anemia have a deficiency of vitamin B12, folic acid, or both. Cyanocobalamin (Nascobal) treats moderate vitamin B12 deficiencies. Patients who have a severe vitamin B12 deficiency should take cyanocobalamin and folic acid.

Deferoxamine (Desferal)

-Indications of iron toxicity include nausea, vomiting, and diarrhea. Iron toxicity can lead to acidosis and shock. A chelating agent, such as deferoxamine, binds to the iron to reduce toxicity.

Aminocaproic acid (Amicar)

-Aminocaproic acid, a coagulator, inhibits fibrinolysis and stops fibrinolytic bleeding. For severe bleeding, patients often require blood replacement.

within 3 hr of symptom onset.

-Alteplase, a thrombolytic drug, is most effective in treating acute myocardial infarction if the patient receives it as soon as possible after the onset of symptoms.

Conjunctivitis is correct. Oprelvekin, a thrombopoietic growth factor, can cause conjunctivitis, blurred vision, and papilledema. Patients should report eye redness or blurred vision.

Tinnitus is incorrect. Oprelvekin, a thrombopoietic growth factor, is unlikely to cause tinnitus. Aspirin (Ecotrin) is a drug that can cause tinnitus.

Swollen ankles is correct. Oprelvekin, a thrombopoietic growth factor, can cause fluid retention. The health care professional should monitor I&O and patients should report edema or difficulty breathing.

Jaundice is incorrect. Oprelvekin, a thrombopoietic growth factor, is unlikely to cause jaundice. However, it can cause fever, rash, and hypotension.

Palpitations is correct. Oprelvekin, a thrombopoietic growth factor, can cause cardiac dysrhythmias. Patients should report palpitations or dizziness.

Hgb

Epoetin alfa, an erythropoietic growth factor, increases the production of RBCs for patients who have anemia due to chronic renal failure or chemotherapy. Hgb and Hct should increase with effective therapy.

Filgrastim (Neupogen)

-Patients who are sensitive to Escherichia coli-derived proteins or have acute respiratory distress syndrome should not receive filgrastim, a leukopoietic growth factor.

Filgrastim (Neupogen)

-Filgrastim, a leukopoietic growth factor, stimulates production of neutrophils in the bone marrow. It helps reduce the risk for infection due to bone marrow transplantation, severe chronic neutropenia, and myelosuppressive chemotherapy.

Increases platelet production

-Oprelvekin, a thrombopoietic growth factor, increases platelet production. It treats thrombocytopenia that is associated with myelosuppression.

Hypertension

-Epoetin alfa, an erythropoietic growth factor, can cause hypertension. The health care professional should monitor blood pressure and regulate it prior to initiating epoetin alfa therapy, then monitor it during therapy. For elevations, recommend a reduced dosage or antihypertensive drug therapy.

Vitamin K

-Vitamin K reverses the effects of warfarin by promoting the synthesis of coagulation factors VI, IX, X, and prothrombin.

Peptic ulcer disease

-Patients who have peptic ulcer disease should not take clopidogrel because it can cause gastric bleeding.

Have emergency equipment ready.

-Factor VIII can cause a hypersensitive reaction and anaphylaxis. The health care professional should monitor for hives, fever, wheezing, and difficulty breathing, and have emergency equipment and drugs readily available.

Eat iron-enriched foods is correct. Patients who have iron-deficiency anemia should increase iron intake with foods such as egg yolks, wheat germ, meat, and fish to supplement ferrous sulfate.

Spread the dosage across each day is correct. Spreading out the iron intake throughout patients' waking hours allows the bone marrow to maximize the production of RBCs.

Take the drug on an empty stomach is correct. Food reduces the absorption of ferrous sulfate. Patients should take the drug on an empty stomach to increase drug absorption. If GI effects are troublesome, patients can take the drug with food.

Report dark green or black stools is incorrect. Health care professionals should tell patients to expect dark green or black stools. It is not necessary to report this effect.

Increase dietary fiber intake is correct. Ferrous sulfate can cause constipation. Patients should increase fiber and fluid intake and exercise more often or more intensely.

Edema

-Desmopressin, an antidiuretic hormone, can cause fluid retention and edema. Health care professionals should monitor fluid intake and output for patients receiving the drug therapy.

Thrombocytopenia

-Clopidogrel, an antiplatelet drug, can cause thrombotic thrombocytopenic purpura. The health care professional should monitor platelet count, bruising, bleeding gums, and petechiae.

Headache

-Alteplase, a thrombolytic drug, can cause intracranial bleeding. Monitor patients receiving the drug for changes in level of consciousness, headache, one-sided weakness, and other indications of intracranial bleeding.

Inhibiting cyclooxygenase action in platelets

-Salicylates, such as aspirin, work by inhibiting platelet aggregation. They do this by blocking the action of cyclooxygenase on platelets. As a result, activation of thromboxane A₂ does not occur.

Insert the needle into the vial once.

-Instructions for administering the drug include inserting the needle into the vial only once. Health care professionals should also examine the solution and discard it if it is cloudy or discolored.