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 ["B","C","D","F"]

Explanation

A. While it's important for older adults to have regular blood tests to monitor their health, showing expected changes in white blood cell counts is not a specific risk factor for infections.
B. Skin tests for tuberculosis may be falsely negative in older adults due to a weakened immune response.
C. Older adults should stay up-to-date on their vaccinations, including influenza, pneumococcal, and shingles vaccinations, to help protect themselves against these infections.
D. Older adults are at increased risk for respiratory tract infections, such as pneumonia, and genitourinary infections, such as urinary tract infections.
E. Booster vaccinations are essential for older adults to maintain protection against diseases such as influenza, tetanus, diphtheria, and pertussis.
F. Older adults may not develop a fever in response to a severe infection. This can make it difficult to recognize the presence of an infection.

A. Ensure that patients with AB+ blood type only receive blood from AB type donors B. Finish transfusing PRBC's within 2 hours C. Remain with the patient during the first 15 minutes of the infusion D. Double check the blood product against the patient blood band with another RN E. Prime blood tubing with normal saline (NS)

Correct Answer is ["B","C","D","E"]

Explanation

A. Individuals with AB+ blood type can receive blood from any donor type (A, B, AB, or O) because they have no antibodies against A or B antigens. The safest practice is to provide the most compatible blood type, but AB+ recipients are considered universal recipients.
B. To minimize the risk of bacterial growth and transfusion reactions, packed red blood cells (PRBCs) should be transfused within 2 hours of starting the infusion. It’s important to monitor the patient closely during this time.
C. The first 15 minutes of a blood transfusion are critical for observing any immediate adverse reactions. The nurse should stay with the patient during this time to monitor vital signs and assess for any signs of a transfusion reaction.
D. A crucial safety step is to verify the blood product against the patient’s blood band with another registered nurse (RN). This helps prevent errors related to mismatched blood transfusions, which can be life-threatening.
E. Blood transfusion tubing should be primed with normal saline to ensure that the blood product flows properly and to maintain patency. Normal saline is used because it is compatible with blood products and does not cause hemolysis.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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