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

Answer and Explanation

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.

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Correct Answer is D

Explanation

A. Timolol is a beta-blocker used primarily to treat glaucoma by reducing intraocular pressure. It would not address the issues presented by this patient, who is likely dealing with alcohol-related complications.
B. Acetaminophen is used to relieve pain and reduce fever. While the patient reports a severe headache, administering acetaminophen may not be advisable due to potential liver damage from alcohol use, especially if the patient has not eaten properly. Chronic alcohol use can also increase the risk of hepatotoxicity with acetaminophen.
C. Aspirin is another pain reliever that could potentially be used for headaches. However, like acetaminophen, it carries risks for patients with alcohol use, particularly gastrointestinal bleeding. Additionally, aspirin should be used cautiously in cases of possible liver impairment.
D. A "banana bag" is a term for an intravenous solution often used in patients with alcohol use disorder to provide hydration and essential vitamins, especially thiamine, which can prevent Wernicke's encephalopathy. It typically contains normal saline or dextrose, electrolytes, and vitamins (including B1, B6, and B12).

A. Can cause sodium and fluid retention. B. Long-term effects include fat redistribution. C. Might make the client feel jittery or nervous. D. Never stop prednisone abruptly.

Correct Answer is D

Explanation

A. Prednisone can lead to sodium and fluid retention, which can result in hypertension and edema. While this is an important consideration, it is not the most critical point to emphasize initially. Managing weight and blood pressure is essential, but there are more immediate concerns with the medication's use.
B. Long-term use of prednisone can result in changes such as fat redistribution, leading to a "moon face," buffalo hump, and increased abdominal fat. This is significant for understanding the side effects of prolonged therapy, but it is not the most urgent information for the client to know.
C. Prednisone can cause side effects such as mood changes, anxiety, or jitteriness, especially when initiating treatment or adjusting dosages. While this is relevant, the potential for emotional or psychological effects is secondary to the critical management of the medication.
D. This is the most critical point to emphasize. Prednisone is a corticosteroid that can suppress the body's natural adrenal function. Abrupt discontinuation can lead to adrenal crisis, which can be life- threatening.

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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?

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Naxlex Comprehensive Predictor Exams

Correct Answer is D

Explanation

A nurse is teaching the client with systemic lupus erythematosus about prednisone. What information is the priority?

Correct Answer is D

Explanation

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