Author Question: The client is pregnant and has been told by her physician that she needs cyanocobalamin (Nascobal). ... (Read 58 times)

Melani1276 · **on:** Jul 23, 2018

The client is pregnant and has been told by her physician that she needs cyanocobalamin (Nascobal). She asks the nurse, Will this hurt my baby? What is the best response by the nurse?

1. No, this medication will not hurt your baby as long as you take it with ascorbic acid.
2. No, this is safe as long as long as you take it in pill form; it is a Pregnancy Category A drug, which means it is safe for your baby.
3. No, this medication will not hurt your baby as long as you take the pills only in the third trimester.
4. No, this is safe in either pill or injectable form; it is a Pregnancy Category A drug which means it is safe for your baby.

Question 2

The physician has prescribed epoetin alfa (Epogen) for the client. What is the priority assessment by the nurse?

1. The client's blood pressure
2. The client's report of a headache, indicating a stroke
3. The client's ability to use the proper injection techniques for self-administration
4. The client's hemoglobin and hematocrit levels

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

Answer to Question 1

Correct Answer: 2
Rationale 1: Ascorbic acid affects the stability of cyanocobalamin (Nascobal), and should not be used concomitantly with cyanocobalamin.
Rationale 2: Cyanocobalamin (Nascobal), oral formulation, is a Pregnancy Category A drug, but it is a Pregnancy Category C when used parenterally.
Rationale 3: There is no evidence to support that oral cyanocobalamin (Nascobal) is teratogenic during the first or second trimesters.
Rationale 4: Cyanocobalamin (Nascobal) is a Pregnancy Category C when used parenterally.

Answer to Question 2

Correct Answer: 1
Rationale 1: The most serious adverse effect of epoetin alfa (Epogen) is hypertension, which can raise blood pressure to dangerous levels, and which occurs in as many as 30 of clients receiving the drug.
Rationale 2: Clients are at risk for a stroke, but this is a complication of uncontrolled hypertension; blood pressure assessment is a priority.
Rationale 3: Assessment of hypertension takes precedence over injection techniques.
Rationale 4: Hemoglobin and hematocrit levels should be assessed, but they are not as high a priority as blood pressure.