Author Question: A patient with cancer is receiving pegfilgrastim (Neulasta). The patient reports bone pain, which ... (Read 89 times)

crazycityslicker · **on:** Jul 23, 2018

A patient with cancer is receiving pegfilgrastim (Neulasta). The patient reports bone pain, which the nurse recognizes as

a. a sign of cancer metastasis.
b. an indication of expansion of bone marrow.
c. caused by osteomyelitis.
d. worsening neutropenia.

Question 2

A patient has been receiving an erythropoietin-stimulating agent (ESA) for 8 weeks. The nurse reviews the patient's chart and notes no increase in hemoglobin levels from 8 g/dL on week 3 of therapy. The nurse will request an order for

a. a complete blood count and serum iron levels.
b. an increased dose of the erythropoietin-stimulating agent.
c. more frequent dosing of the ESA.
d. packed red blood cell infusions.

nathang24 · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

ANS: B
Bone pain is common with these drugs and is caused by expansion of the bone marrow. It does not indicate metastasis. The bone pain is not due to osteomyelitis or neutropenia.

Answer to Question 2

ANS: A
If there is no response, ESAs should be discontinued after 8 weeks of therapy. If a patient does not respond, iron deficiency or underlying hematologic disease should be considered and evaluated.