A nurse is reviewing agency protocol prior to administering epoetin alfa to a client who has chronic kidney disease.
Which of the following actions should the nurse plan to take?
Discard the vial of medication if the solution is cloudy.
Shake the vial of medication to dissolve particulates.
Dilute the vial of medication with sterile water.
Thaw the medication in the vial 30 min before administration.
The Correct Answer is A
Discard the vial of medication if the solution is cloudy.
This is because epoetin alfa should not be used if it has been frozen or if it has changed color or has particles in it.
Choice B is wrong because the vial should not be shaken before use.
Choice C is wrong because epoetin alfa should not be diluted with sterile water or any other liquid.
Choice D is wrong because epoetin alfa should not be frozen and therefore does not need to be thawed before administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Nasal cyanocobalamin is a form of vitamin B12 that is used to treat pernicious anemia.
It is typically administered once per week into one nostril.
Choice B is wrong because there is no need to lie down for 1 hour after administering the medication.
Choice C is wrong because using a nasal decongestant before administering the medication is not necessary and may interfere with the absorption of the medication.
Choice D is wrong because the duration of treatment with nasal cyanocobalamin varies and should be determined by the provider based on the client’s individual needs.
Correct Answer is C
Explanation
- A. Assist the client to a left lateral position.
- This is generally used for clients at risk of aspiration, and it's not indicated based on the lithium level.
- B. Implement fluid restrictions.
- Fluid restrictions are usually implemented when there is a risk of fluid overload or hyponatremia, and not in this case. In fact, dehydration can raise lithium levels to toxic levels, so proper hydration is important.
- C. Request a dosage increase from the provider.
- While 0.6 mEq/L is within the therapeutic range, some providers may want to see a level slightly higher for maintenance. So requesting a dosage increase from the provider is the correct action.
- D. Prepare the client for hemodialysis.
- Hemodialysis is used to remove lithium from the blood in cases of severe lithium toxicity, which is indicated by levels significantly higher than 1.5 mEq/L. This is not needed when the lithium level is 0.6 mEq/L.
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