Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharmacology > ATI section 6: Medications for the Hematologic system > Flashcards

ATI section 6: Medications for the Hematologic system Flashcards

1
Q

Blood and Blood Products

A

-Whole blood, Packed red blood cells (RBCs), Platelet concentrations

Nursing Interventions and Client Education:
-Client ID, name, and blood types must be verified by 2 nurses
-Prior to administration, assess baseline vital signs, including temp
-Establish IV access, 18-guage or larger catheter
-Must have 0.9% sodium chloride primed tubing
-For the first 15 min, stay with the client and infuse slowly, monitoring for any reaction
-If reaction occurs perform the following:
Stop blood immediately and take vital signs
Infuse 0.9% sodium chloride
Notify the provider
Follow facility policy (send urine sample, CBC, and bag tubing to lab for analysis
-Complete infusion of product within 4hrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Whole Blood

A

Time completed:
-2-4 hrs

Action/Therapeutic Use:
-Replace volume: Hemorrhage, surgery, trauma, burns, shock

Monitor for Reaction:
-Acute hemolytic, febrile, anaphylactic, mild allergic, hypervolemia, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Packed RBCs

A

Time completed:
-2-4 hrs

Action/Therapeutic Use:
-Increase available RBC, severe anemia, hemoglobulinopathies, hemolytic anemia, erythroblastosis fetalis

Monitor for Reaction:
-Acute hemolytic, febrile, anaphylactic, mild allergic, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Platelets

A

Time completed:
-15-30 min

Action/Therapeutic Use:
-Increase platelet count, active bleeding, thrombocytopenia, aplastic anemia, bone marrow suppression

Monitor for Reaction:
-Febrile, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

FFP

A

Time completed:
-30-60 min

Action/Therapeutic Use:
-Replace clotting factors, hemorrhage, burns, shock, thrombotic thrombocytopenia purport (TTP), reverse effects of warfarin

Monitor for Reaction:
-Acute hemolytic, febrile, anaphylactic, mild allergic, hypervolemia, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pheresed granulocytes

A

Time completed:
-45-60

Action/Therapeutic Use:
-severe neutropenia, neutrophil dysfunction, neonatal sepsis

Monitor for Reaction:
-Acute hemolytic, febrile, anaphylactic, mild allergic, hypovolemia, sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Albumin

A

Time completed:
-5% (1-10 mL/min), 25% (4mL/min)

Action/Therapeutic Use:
-Expand vol via oncotic changes, hypovolemia, hypoalbuminemia, burns, severe nephrosis, hemolytic disease of the newborn

Monitor for Reaction:
-Risk for hypervolemia and pulmonary edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Hematopoietic Growth Factors

A

Action: stimulate the bone marrow to synthesize the specific blood cells

-Epoetin alfa (Procrit), Filgastrim (Neupogen) injection, Pegfilgastrim (Neulasta) IV, Orelvekin (Neumega)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Epoetin alfa (Procrit)

A

Therapeutic Uses:
-stimulate RBC production
-Anemia related to:
CKD, Retrovir therapy, chemo

Side/Adverse effects:
-Hypertension

Nursing Interventions:
-SubQ or IV: do not agitate vial, monitor Hct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Filgastim (Neupogen) injection

Peffilgrastim (Neulasta) IV over 2-4 hrs

A

Therapeutic Uses:

  • Stimulate WBC production
  • Neutropenia related to cancer

Side/Adverse effects:

  • Bone pain
  • Leukocytosis

Nursing Interventions:

  • SubQ or IV
  • Do not agitate vial
  • Monitor CBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oprelvekin (Neumega)

A

Therapeutic Uses:

  • Stimulate platelet production
  • Thrombocytopenia related to cancer

Side/Adverse effects:

  • Fluid retention
  • Papilledema
  • Cardiac dysrhythmia

Nursing Interventions:

  • Administer within 6-24 after chemo
  • SubQ
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Iron Preparations

Oral

A
  • Dilute with water or juice and administer with a plastic straw or medication dosing syringe (avoid contact with teeth)
  • Encourage OJ fortified with vitamin C (facilitates absorption)
  • Avoid antacids, coffee, tea, dairy products, or whole grain breads concurrently and for 1 hr after admin due to decreased absorption
  • Monitor the client for constipation and gastrointestinal upset
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Iron Preparations

IM

A
  • Use a large-bore needle (19-20 gauge, 3 inch)
  • Change needle after drawing up from vial
  • Z-track (ventrogluteal preferable)
  • Do not massage injection site
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Anticoagulants

A

-Heparin Sodium and Enoxaparin (Levenox) (Parenteral medication)

Therapeutic Uses:

  • Evolving stroke
  • Pulmonary embolism
  • Massive deep-vein thrombosis
  • Cardiac catheterization
  • MI
  • DIC

Precautions/Interactions:

  • Must be given subQ or IV
  • Incompatible with many medications
  • Avoid NSAIDs, aspirin, or medication containing salicylate

Side/Adverse effects:

  • Hemorrhage
  • Heparin-induced thrombocytopenia
  • Toxicity/overdose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Anticoagulant

Nursing Interventions and Client Education

A
  • Clients receiving heparin: monitor aPPT every 4-6 hrs for IV administration
  • Monitor for signs of bleeding
  • Safety precautions to prevent bleeding
  • Administer subQ heparin to abdomen, 2 inches form umbilicus (do not aspirate or massage)
  • Rotate injection site and observe for bleeding hematoma
  • Administer protamine sulfate for heparin toxicity (1 mg neutralizes 100 units of heparin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Warfarin (Coumadin) oral medication

A

Therapeutic Uses:

  • Venous thrombosis
  • Thrombus prevention for clients with atrial fibrillation or prosthetic heart valves
  • Prevention of recurrent MI
  • Transient ischemic attacks (TIAs)

Precautions/Interactions:

  • Pregnancy
  • Contraindications: thrombocytopenia, carbamazepine (Tegretol, phenytoin (Dilantin), oral contraceptives
  • Food sources high in vitamin K may decrease effects

Side/Adverse effects:

  • hemorrhage
  • toxicity/overdose
17
Q

Warfarin (Coumadin) oral medication

Nursing Interventions and Client Education

A
  • Administer once daily
  • Monitor INR or PT
  • Teach client that bleeding risk remains put to 5 days after discontinued therapy
  • Avoid NSAIDs, and medication with aspirin
  • Teach client to wear a medical alert bracelet
  • Client may self-monitor for PT/INR
  • Teach measures to prevent injury and bleeding
  • Administer vitamin K for warfarin toxicity
  • Garlic, ginger, ginko, and ginseng may increase risk of bleeding
18
Q

Dabigatran (Pradaxa) (Oral medication)

A

Therapeutic Uses:
-reduces the risk of stroke and embolism for clients with nonvalvular atrial fibrillation

Precautions/Interventions:

  • Must discontinue warfarin and start dabigatran when INR is below 2.0
  • When possible , discontinue 1-2 days prior to surgical procedure

Side/Adverse effects;

  • Bleeding
  • GI discomfort
19
Q

Dabigatran (Pradaxa) (Oral medication)

Nursing Interventions and Client Education

A
  • Take med daily and avoid skipping doses
  • If a dose is missed, it should not be taken within 6hrs of the next scheduled dose
  • Tabs should not be crushed, broken, or chewed
  • Teach client to avoid NSAIDs and medications with aspirin
  • Teach client to monitor for signs of GI bleeding
20
Q

Antiplatelet Medications

A

-Aspirin, Abciximab, clopidogrel, ticipidine, pentoxifylline, dipyridamole

Therapeutic Uses:

  • prevention of acute myocardial infarction or acute coronary syndromes
  • prevention of stroke
  • Intermittent claudication

Precautions/Interactions:

  • Contraindicated in thrombocytopenia
  • Caution with peptic ulcer disease

Side/Adverse effects:

  • Prolonged bleeding
  • Gastric bleeding
  • Thrombocytopenia

Nursing Interventions and Client Education

  • Monitor for signs of prolonged bleeding
  • Teach client to report tarry stool, ecchymosis
21
Q

Thrombolytic Medications

A

-Suffix: teplase

Therapeutic Uses:

  • Acute myocardial infarction
  • Deep vein thrombosis (DVT)
  • Massive pulmonary emboli (PE)
  • Ischemic stroke (alterplase)

Precautions/Interactions:

  • Contraindicated for intracranial hemorrhage, active internal bleeding, aortic dissection, brain tumors
  • Use cautiously when using gin clients who have severe hypertension
  • Concurrent use of anticoagulants or anti platelet meds increases risk for bleeding

Side/Adverse effects:

  • Serious bleeding risks from recent wounds, puncture sites, weakened vessels
  • Hypotension
  • Possible anaphylactic reaction

Nursing Interventions and Client Education:

  • Administer must take place within 4-6 hrs of symptom onset
  • Continuous monitoring is required
  • Clients will begin anticoagulant therapy to prevent repeated thrombotic event

Pharmacology (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions