Unformatted text preview: ss and tingling in her hands and feet? Is
treatment needed? If so, why?
2. Ms. B sees a primary care provider for treatment. She subsequently returns to
the neighborhood nursing clinic and tells the nurse she is very concerned
because she used to take the B12 supplement by injection, and now her
physician wants her to take it in the form of a nose spray. Ms. B tells the nurse
that the physician must not know the correct treatment and that she will not be
fooled into thinking a nose spray will help her. How should the nurse respond?
3. How should the nurse respond to Ms. B’’s questions about how long she will
continue to have numbness and tingling in her hands and feet?
89 Critical Thinking Case Study
You are the student nurse assigned to care for Mr. T, a 50 -year-old
patient with chronic renal failure. He weighs 70 kg. He has had
hemodialysis three times a week for the past 2 weeks, and he
recently was started on epoetin alfa therapy.
1. Based on the pathophysiology of chronic renal failure, you should
be particularly alert for which adverse effects of epoetin alfa? What
can be done to minimize the adverse effects of epoetin alfa in a
patient with chronic renal failure?
2. Mr. T asks you why he has to get the epoetin alfa by injection. He
tells you, “I hear from the other patients here that the shots hurt and
that the drug really doesn’t get into my system. Why can’t you just
put the medicine into the dialysis machine?” What is your most
90 Example Test
Questions 91 Fill in the Blank
1. The most commonly prescribed
The coagulation modifiers are the_________.
2. The________are a class of drugs that
dissolve life-threatening clots.
3. Two laboratory tests used to determine
the anticoagulation effects of Coumadin
are_________and_________. 92 A patient being started on an
anticoagulant would be told that the
primary goal of drug therapy is to:
A. Dissolve the existing thrombus.
B. Prevent further thrombus formation.
C. Stabilize an existing thrombus.
D. Prevent the thrombus from becoming an
embolus. 93 The nurse should plan to teach a
patient who is beginning to receive
warfarin (Coumadin) therapy to limit
intake of which of the following
A. Red meat
B. Citrus fruit
C. Green leafy vegetables
D. Mail and milk products
94 A patient receiving anticoagulant
therapy should be encouraged by
the nurse to use which of the
following drugs when an analgesic is
A. Acetaminophen (Tylenol)
B. Aspirin (Ecotrin)
C. Naproxen (Naprosyn)
D. Ibuprofen (Motrin)
95 A patient is receiving an intravenous infusion of
heparin to treat a pulmonary embolism. What
laboratory value will the nurse monitor
to evaluate the treatment with this medication?
to A. Activated partial thromboplastin time
B. Prothrombin time (PT)
D. Hemoglobin and hematocrit
96 A patient has indications of an ST-elevation
myocardial infarction. Which five medications
would the nurse consider routine
therapy for this patient?
A. Beta blocker, angiotensin II receptor blocker
clopidogrel, and heparin
B. Aspirin, angiotensin-converting enzyme (ACE)
inhibitor, diuretic, warfarin, and morphine
C. Aspirin, beta blocker, oxygen, morphine, and
D. Heparin, oxygen, nitroprusside, ACE inhibitor, and
morphine A woman asks the nurse why a vitamin with
folic acid is needed during pregnancy. The
A. inform the woman that folic acid prevents neural
tube defects in the fetus.
B. refer the woman to her healthcare provider for
C. instruct the woman about the benefits of folic
acid to prevent premature birth during
D. teach the woman how folic acid taken during
pregnancy prevents cerebral palsy.
98 A patient receives a dose of epoetin alfa
(Epogen) 3 times per week. What laboratory
value will the nurse monitor to determine the
therapeutic benefit of this medication? A. White blood cell count
C. Serum potassium
D. Platelet count 99...
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