Your cancer patient has bone marrow suppression from their chemotherapy treatments, and is scheduled to receive Epoetin Alfa shots 3 times per week. Which of the following lab values would cause you to hold the administration of the medication for safety concerns?
Hgb of less than 11
aPTT of 120 seconds
Hgb of more than 11
PT/INR of 3.5
The Correct Answer is C
A. Epoetin Alfa is typically used to treat anemia, and it is often indicated when hemoglobin (Hgb) levels are below 11 g/dL. Therefore, if the Hgb is less than 11, it would be appropriate to administer the medication to help increase red blood cell production.
B. Do not hold. An activated partial thromboplastin time (aPTT) of 120 seconds indicates a prolonged coagulation time, which increases the risk of bleeding. However, Epoetin Alfa does not have a direct impact on coagulation, so this value alone would not warrant holding the medication.
C. Epoetin Alfa is generally not indicated if the Hgb level is already above 11 g/dL, particularly if there’s a risk of increasing the Hgb above the recommended therapeutic range (often above 12 g/dL). If the Hgb exceeds this level, the medication should be held to prevent complications such as thromboembolic events.
D. A PT/INR of 3.5 indicates a significantly prolonged prothrombin time, suggesting a high risk of bleeding. However, Epoetin Alfa does not directly cause bleeding.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A sudden new pain in a patient with SCD can be a sign of a serious complication, such as acute chest syndrome or stroke. Prompt medical evaluation is crucial to identify and address any underlying complications.
B. While an X-ray may be helpful to rule out other causes of shoulder pain, it is not the most urgent priority in this case. The patient's sudden onset of pain could be a sign of a serious complication that requires immediate attention.
C. While a head-to-toe assessment is important for any patient, it is not the most urgent priority in this case. The patient's new pain could be a sign of a serious complication that requires immediate medical attention.
D. Increasing the opioid dosage may provide temporary relief from the pain, but it does not address the underlying cause of the new pain.
Correct Answer is A
Explanation
A. This statement indicates some understanding of self-care, as using gentle hair products can help minimize irritation. However, it's not specifically focused on the most critical aspects of SLE management related to skin care.
B. Clients with SLE should inspect their skin regularly, not just once a month, as they are at a higher risk for rashes and skin lesions. More frequent self-assessment can help catch any changes early.
C. Clients with SLE are generally advised to avoid tanning beds altogether, as ultraviolet (UV) exposure can exacerbate skin rashes and trigger flares of the disease. Limiting exposure to UV light is essential for managing lupus.
D. Applying powder to a rash may not be advisable, as it could irritate the skin further. Clients should be taught to keep the affected areas clean and follow their healthcare provider's recommendations for treating rashes.
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