A patient with renal failure is undergoing chronic hemodialysis. ...

[rlane42]

A patient with renal failure is undergoing chronic hemodialysis. The patient's hemoglobin is 10.6 gm/dL. The provider orders sodiumferric gluconate complex (SFGC Ferrlecit). What will the nurse expect to do?
 
  a. Administer the drug intravenously with erythropoietin.
  b. Give a test dose before each administration of the drug.
  c. Have epinephrine on hand to treat anaphylaxis if needed.
  d. Infuse the drug rapidly to achieve maximum effects quickly.

Question 2

A nurse is caring for a patient with hemophilia A who has been admitted for bleeding into the knee joint.
 
  The prescriber has ordered intravenous factor VIIa (NovoSeven RT). A nursing student wants to know why this patient is not receiving factor VIII. Which statement by the nurse is correct?
  a. Factor VIIa is stronger than factor VIII and will work faster.
  b. Factor VIII is used for prophylaxis, and factor VIIa is used for acute episodes.
  c. Factor VIIa is used when patients develop antibodies against factor VIII.
  d. Factor VIIa provides immune tolerance therapy so that factor VIII will be more effective.

[amanda_14]

Answer to Question 1

ANS: A
SFGC is given parenterally for iron deficiency anemia in patients undergoing chronic hemodialysis. It is always used in conjunction with erythropoietin to stimulate production of red blood cells (RBCs). A test dose is given only with the initial dose and is not necessary with subsequent doses. Anaphylaxis is not a common side effect. The drug should be infused slowly.

Answer to Question 2

ANS: C
When patients develop antibodies against factor VIII, activated factor VII is used, because it has the same actions as factor VIII. Factor VIIa is not stronger than factor VIII. It is not used for prophylaxis only. Immune tolerance therapy describes the use of repeated administration of factor replacement products to eliminate inhibitor production.

[rlane42]

Thank you!

[amanda_14]

Always glad to help...