The health care provider has ordered darbepoetin alfa (Aranesp) ...

[ap345]

The health care provider has ordered darbepoetin alfa (Aranesp) for a client who has anemia secondary to chemotherapy. What teaching should the nurse provide to the client?
 
  Standard Text: Select all that apply.
  1. This medication will help to increase your red blood cell count.
  2. You can take this medication by mouth.
  3. You will need to come in once a week for this medication.
  4. This drug has fewer side effects than the epoetin alfa we used to give.
  5. You should see maximum results from this medication in 2 to 4 weeks.

Question 2

The nurse is reviewing lab work prior to administering a client's regularly scheduled subcutaneous injection of epoetin alfa.
 
  The nurse notes that the client's hematocrit has dropped from the last time lab was drawn. Which action by the nurse is the most appropriate?
  Standard Text: Select all that apply.
  1. Discuss this finding with the client's health care provider immediately.
  2. Schedule another hematocrit test tomorrow.
  3. Give the epoetin alfa and hold pressure on the injection site for 5 minutes.
  4. Ask the client, How have you been feeling?
  5. Ask the lab to verify the lab results.

[dyrone]

Answer to Question 1

Correct Answer: 1,3,5
Rationale 1: Increasing red blood cell count is the desired effect of darbepoetin alfa.
Rationale 2: Darbepoetin alfa is administered subcutaneously or intravenously.
Rationale 3: The benefit of darbepoetin alfa over epoetin alfa is that it has a longer duration of action and can be given once a week.
Rationale 4: Both drugs have similar adverse effects and the same black box warning.
Rationale 5: Maximum response occurs in 2 to 4 weeks.
Global Rationale: Increasing red blood cell count is the desired effect of darbepoetin alfa. The benefit of darbepoetin alfa over epoetin alfa is that it has a longer duration of action and can be given once a week. Maximum response occurs in 2 to 4 weeks. Darbepoetin alfa is administered subcutaneously or intravenously. Both drugs have similar adverse effects and the same black box warning.

Answer to Question 2

Correct Answer: 1,4,5
Rationale 1: Some clients with chronic renal failure develop neutralizing antibodies to subcutaneous epoetin alfa, which can lead to a rapidly developing severe anemia known as pure red cell aplasia.
Rationale 2: If the client is developing pure red cell aplasia, waiting until tomorrow could be a critical error.
Rationale 3: The epoetin alfa should be held.
Rationale 4: Asking how the client has been feeling is the first step in assessing whether anemia is developing.
Rationale 5: A decrease in hematocrit is not the expected effect of administering epoetin alfa and may signal a severe adverse effect. The lab result should be verified.
Global Rationale: Some clients with chronic renal failure develop neutralizing antibodies to subcutaneous epoetin alfa, which can lead to a rapidly developing severe anemia known as pure red cell aplasia. Asking how the client has been feeling is the first step in assessing whether anemia is developing. A decrease in hematocrit is not the expected effect of administering epoetin alfa and may signal a severe adverse effect. The lab result should be verified. If the client is developing pure red cell aplasia, waiting until tomorrow could be a critical error. The epoetin alfa should be held.

[ap345]

TYSM

[matt95]

Excellent