The nurse is reviewing a patient's health history. The nurse ...

[Anajune7]

The nurse is reviewing a patient's health history. The nurse recognizes that the therapeutic applications for epoetin alfa include which of the folllowing? (Select all that apply.)
 
  a. Anemia of chronic renal failure (CRF).
  b. Patients with AIDS.
  c. Chemotherapy-induced anemia.
  d. Anemia in patients going to surgery.
  e. Patients with HIV who take zidovudine (AZT).
  f. Patients with tuberculosis.

Question 2

A nurse is evaluating a patient with HIV who takes zidovudine (AZT) for possible treatment with epoetin alfa.
 
  The nurse notices that the laboratory report shows endogenous erythropoietin levels of 550 milliunits/mL. To keep the treatment optimal and at a therapeutic level, what would be the most appropriate nursing action?
  a. Administer the epoetin alfa as ordered.
  b. Contact the prescriber to determine whether the dosage should be reduced.
  c. Contact the prescriber to see whether the dosage should be increased.
  d. Confer with the prescriber to see whether the order should be discontinued.

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Answer to Question 1

ANS: A, C, D, E
Therapeutic uses for epoetin alfa include anemia of CRF; chemotherapy-induced anemia; anemia in patients facing surgery; and patients with HIV who take zidovudine.
Epoetin alfa is not indicated for patients with AIDS or tuberculosis.

Answer to Question 2

ANS: A
If endogenous levels of erythropoietin are at or above 500 milliunits/mL, raising them further with epoetin alfa is unlikely to help so the nurse needs to discuss the lab result and what the lowered dose should be with the prescriber.
The patient's erythropoietin level is too high so the nurse needs to discuss what dose would be best with the prescriber before giving more erythropoietin.
This is incorrect since the lab result is too high so the patient needs a lower dose of erythropoietin.
Since anemia is a side effect of Zidovudine, it is likely he will need some dose of erythropoietin to maintain hemoglobin levels. Treatment with erythropoietin can maintain or elevate erythrocyte counts and reduce the need for transfusions.

[Anajune7]

TYSM

[FergA]

Excellent