A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?

Erythropoietin (Epogen)

Eltrombopag (Promacta)

GM-CSF (Leukine)

Thrombopoietin (TPO)

Answer and Explanation

The Correct Answer is A

A. Erythropoietin (Epogen):
Explanation: Erythropoietin is a hormone that stimulates the production of red blood cells. In chronic kidney disease, especially when associated with anemia, the production of erythropoietin by the kidneys may be reduced. Erythropoietin (Epogen) is commonly used to stimulate the production of red blood cells and manage anemia in patients with chronic kidney disease.

B. Eltrombopag (Promacta):
Explanation: Eltrombopag is a medication used to stimulate the production of platelets and is primarily indicated for conditions associated with thrombocytopenia (low platelet count). It is not used to treat anemia associated with chronic kidney disease.

C. GM-CSF (Leukine):
Explanation: Granulocyte-macrophage colony-stimulating factor (GM-CSF or Leukine) is a medication that stimulates the production of white blood cells and is used in certain conditions to address decreased white blood cell counts. It is not typically used for managing anemia.

D. Thrombopoietin (TPO):
Explanation: Thrombopoietin is a hormone that stimulates the production of platelets. Medications that mimic the action of thrombopoietin, such as romiplostim and eltrombopag, are used to treat thrombocytopenia. Thrombopoietin is not used for the treatment of anemia.

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Correct Answer is C

Explanation

A. pH 7.28, pCO2 36, HCO3 23:
Explanation: The pH is low, indicating acidosis. However, the pCO2 is within the normal range, which is not consistent with respiratory acidosis. The HCO3 is slightly low but not significantly, and this doesn't align with typical findings in respiratory acidosis.

B. pH 7.52, pCO2 28, HCO3 25:
Explanation: The pH is high, indicating alkalosis. The pCO2 is below the normal range, which is not consistent with respiratory acidosis. The HCO3 is within the normal range, and these values are not typical for respiratory acidosis.

C. pH 7.25, pCO2 50, HCO3 22:
Explanation: The pH is low, indicating acidosis. The pCO2 is elevated, which is typical in respiratory acidosis. The HCO3 is within the normal range, suggesting uncompensated respiratory acidosis.

D. pH 7.35, pCO2 40, HCO3 24:
Explanation: The pH is within the normal range, and both pCO2 and HCO3 are normal. These values do not indicate acidosis.

A. I will report nausea, vomiting, or diarrhea to my primary care provider. B. I should avoid carbohydrates when I'm sick. C. I should stop taking my insulin or oral antidiabetic agents. D. I will test my blood glucose and test urine ketones every 3 to 4 hours. E. I will continue taking my insulin or oral antidiabetic agents as usual.

Correct Answer is ["A","D","E"]

Explanation

A. I will report nausea, vomiting, or diarrhea to my primary care provider.
Correct Understanding: This is correct. Reporting these symptoms is essential because illness, especially with symptoms like nausea, vomiting, or diarrhea, can impact blood glucose levels.

B. I should avoid carbohydrates when I'm sick.
Need for Further Teaching: During illness, it's important to continue consuming carbohydrates. However, the type and amount of carbohydrates might need to be adjusted. Patients should consult their healthcare providers for guidance on managing carbohydrate intake during illness.

C. I should stop taking my insulin or oral antidiabetic agents.
Need for Further Teaching: It is not advisable to stop insulin or oral antidiabetic agents during illness. In fact, these medications often need to be continued, with potential adjustments made under the guidance of healthcare providers.

D. I will test my blood glucose and test urine ketones every 3 to 4 hours.
Correct Understanding: This is correct. Regular monitoring of blood glucose and urine ketones during illness is crucial for managing diabetes and detecting any potential complications.

E. I will continue taking my insulin or oral antidiabetic agents as usual.
Correct Understanding: This is correct. It's important to continue taking insulin or oral antidiabetic agents during illness to help manage blood glucose levels.

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A client with chronic kidney disease has chronic anemia. What pharmacologic alternative to blood transfusion may be used for this patient?

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Explanation

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Explanation

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