Chapter 48: Immunostimulants and Immunomodulators Introductory Clinical Pharmacology 12th Edition by Susan M Ford

Introductory Clinical Pharmacology 12th Edition by Susan M Ford 1. A nurse is preparing to administer ferrous to a client. Which adverse reaction should the nurse point out to the client to report if noted? a. Headache b. Allergic reaction c. Soreness d. Backache Answer: B Rationale: The nurse needs to closely monitor the client for an allergic reaction and report to the health care provider if symptoms are noted. Headache and backache are the generalized system reactions to iron supplements. Soreness is a generalized system reaction to the administration of iron when given through the parenteral route. Question format: Multiple Choice Chapter: 48 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 660, Summary Drug Table 2. A nurse is conducting the preadministration assessment on a client who is prescribed ferrous and notes the client is also currently prescribed ascorbic acid. Which potential reaction of these two drugs should the nurse prioritize for monitoring? a. An increase in seizure activity b. Signs of vitamin B12 deficiency c. Increased absorption of iron d. Signs of folate deficiency Answer: C Rationale: The nurse should monitor for an increased absorption of iron in the client due to the interaction of ascorbic acid with the iron preparation, ferrous. An increase in seizure activity may occur when folic acid is administered with the hydantoins. Signs of folate deficiency may occur when sulfasalazine is administered concurrently. Vitamin B12 deficiency is a rare deficiency caused by a low dietary intake. Question format: Multiple Choice Chapter: 48 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 655, Generalized System Reactions 3. A client with megaloblastic anemia is prescribed leucovorin. The nurse would question administration of this drug if which additional disorder is noted in the client's medical record? a. Pernicious anemia b. Hemochromatosis c. Uncontrolled hypertension d. Hypersensitivity to human albumin Answer: A Rationale: Leucovorin is contraindicated in clients with pernicious anemia or other anemias in which vitamin B12 is deficient. Leucovorin is not contraindicated in clients with hemochromatosis, uncontrolled hypertension, and hypersensitivity to human albumin. Epoetin alfa is contraindicated in clients with uncontrolled hypertension and hypersensitivity to human albumin. Iron compounds are contraindicated in clients with hemochromatosis or hemolytic anemia. Question format: Multiple Choice Chapter: 48 Learning Objective: 5 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Clinical Problem-solving Process (Nursing Process) Reference: p. 656, Folic Acid Deficiency 4. A nurse is caring for a client with iron deficiency anemia who is receiving iron supplements. What information should the nurse point out in the teaching plan for this client? a. Frequency of urination will increase. b. Soreness of throat might occur. c. Itching of throat might occur. d. Color of stools will become darker. Answer: D Rationale: The nurse should inform the client receiving oral iron supplements that the color of stools will become darker. Frequency of urination is not known to increase with the oral administration of iron supplements. Similarly, soreness of the throat and itching of the throat are also not known to occur with the oral administration of iron supplements. Question format: Multiple Choice Chapter: 48 Learning Objective: 8 Cognitive Level: Apply Client Needs: Physiological Integrity: Pharmacological Therapies Integrated Process: Teaching/Learning Reference: p. 657, Ongoing Assessment 5. The nurse is preparing discharge teaching for a client with anemia who is prescribed epoetin alfa for the next week. Which instruction should the nurse prioritize to the client? a. Avoid use of multivitamin preparations. b. Report signs of joint pain to the primary health care provider. c. Follow the recommended diet provided by the primary health care provider. d. Take the drug on an empty stomach or with water. Answer: B Rationale: When caring for a client who is to take epoetin alfa for anemia, the nurse should instruct the client to report any signs of joint pain, dizziness, headache, fatigue, nausea, vomiting, or diarrhea to the primary health care provider. The nurse should instruct the client to avoid taking multivitamin preparations and to follow the diet recommended by the primary health care provider when caring for a client who has to take folic acid. The nurse should instruct the client to take the drug on an empty stomach or with water when caring for a client who has to take iron supplements on an outpatient basis. Question format: Multiple Choice Chapter: 48 Learning Objective: 8 Cognitive Level: Apply Client Needs: Physiological Integrity: Reduction of Risk Potential Integrated Process: Teaching/Learning Reference: p. 659, Hematopoietic Factors 6. A nurse is caring for a client with hypertension and anemia. Which action would the nurse include in the plan of care when administering epoetin alfa to the client?