Erythropoiesis-Stimulating Agents

Question 1

Erythropoiesis-Stimulating Agents: Names and uses

Answer 1

Epoetin Alfa
◦Treats anemia associated with renal failure and AIDS, decreases need for blood transfusions in patients undergoing surgery

Darbopoetin Alfa
◦Treats anemia associated with chronic renal failure, including patients on dialysis

Question 2

Erythropoiesis-Stimulating Agents: Actions

Answer 2

Acts like the natural glycoprotein erythropoietin to stimulate the production of RBC’s in the bone marrow

Question 3

Erythropoiesis-Stimulating Agents: Indications

Answer 3

Treats anemia associated with chronic renal failure to reduce the need for allogenic blood transfusions in surgical patients

Question 4

Erythropoiesis-Stimulating Agents: Contraindications

Answer 4

◦Uncontrolled hypertension
◦Allergy to mammalian cell-derived
◦Allergy to human albumin

Question 5

Erythropoiesis-Stimulating Agents: Cautions

Answer 5

◦Normal renal function
◦Renal dysfunction
◦Pregnancy and lactation

Question 6

Erythropoiesis-Stimulating Agents: Adverse Effects

Answer 6

◦CNS – Headache, fatigue, asthenia, dizziness, and seizure
◦Nausea, vomiting, and diarrhea
◦CV – Hypertension, edema, possible chest pain

Question 7

Erythropoiesis-Stimulating Agents: Drug Interactions

Answer 7

◦Should not be mixed in solution with other drugs

Question 8

Erythropoiesis-Stimulating Agents: Assessment

Answer 8

◦History and physical exam and known allergies
◦Severe hypertension, pregnancy, anemia and abnormal renal function
◦Patients with cancer receiving the drugs to increase hematocrit after antineoplastic chemotherapy
◦Neurological and CV status, respirations
◦Appropriate lab value

Question 9

Erythropoiesis-Stimulating Agents: Nursing Diagnosis

Answer 9

◦Nausea related to adverse GI effects
◦Diarrhea related to GI effects
◦Risk for injury related to CNS effects
◦Risk for imbalanced fluid volume related to CV effects
◦Deficient knowledge regarding drug therapy

Question 10

Erythropoiesis-Stimulating Agents: Implementation

Answer 10

◦Confirm the chronic, renal nature of the patient’s anemia before administering the drug
◦Give epoetin alfa three times per week, either IV or subcutaneously
◦Provide the patient with a calendar of marked days
◦Do not mix with any other drug solution
◦Monitor lines for clotting
◦Ensure that prescribed laboratory testing, such as hematocrit levels, is completed before drug administration
◦Evaluate iron stores before and periodically during therapy
◦Monitor blood pressure due to risk for hypertension
◦Maintain seizure precautions on standby
◦Provide thorough patient teaching

Question 11

Erythropoiesis-Stimulating Agents: Evaluation

Answer 11

◦Monitor patient response to the drug (alleviation of anemia, target hemoglobin level a maximum of 11 g/dL)
◦Monitor for adverse effects (headache, hypertension, nausea, vomiting, seizures, dizziness)
◦Monitor the compliance with the regimen
◦Evaluate the effectiveness of the teaching plan