Author Question: A patient with a hemoglobin of 7.2 gm/dL begins therapy with an ESA. Two weeks later the patient's ... (Read 25 times)

CharlieWard · **on:** Jul 23, 2018

A patient with a hemoglobin of 7.2 gm/dL begins therapy with an ESA. Two weeks later the patient's hemoglobin is 8.3 gm/dL. The nurse anticipates that the provider will:

a. reduce the ESA dose.
b. discontinue the ESA.
c. order a blood transfusion.
d. order heparin.

Question 2

A young adult woman will begin using an inhaled glucocorticoid to treat asthma. The nurse will teach this patient about the importance of which action?

a. Lowering her calcium intake and increas-ing her vitamin D intake
b. Participating in weight-bearing exercises on a regular basis
c. Taking oral glucocorticoids during times of acute stress
d. Using two reliable forms of birth control to prevent pregnancy

swimkari · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

A
The patient's hemoglobin has risen just over 1 gm/dL in 2 weeks, so the dose of ESA should be reduced. The ESA should be discontinued when the hemoglobin is greater than 13 gm/dL. A blood transfusion is not indicated. Heparin is used when patients are undergoing dialysis.

Answer to Question 2

B
Like oral glucocorticoids, inhaled glucocorticoids can promote bone loss in premenopausal women. Patients should be encouraged to participate in weight-bearing exercises to help minim-ize this side effect. Patients should increase both their calcium and vitamin D intakes. Patients taking oral glucocorticoids need increased steroids in times of stress. It is not necessary to use two reliable forms of birth control.