A patient coming to the clinic for a weekly infusion of darbepoetin alpha (Aranesp) has all of the following changes. For which change does the nurse hold the dose of the drug?
a. Weight loss of five pounds
b. Hemoglobin increase from 8 g/dL to 10 g/dL
c. Blood potassium increase from 3.8 mEq/L to 4.8 mEq/L
d. Blood pressure increase from 126/80 mm Hg to 148/92 mm Hg
D
Because these drugs increase blood cell production, the blood becomes more viscous (thicker). This effect raises blood pressure, increases clot formation, and slows blood movement through small vessels. This patient is hypertensive, so the next dose of darbepoetin can increase the pres-sure to dangerous levels and greatly increase the risk for stroke and heart attack. The drug should not be administered until the patient's blood pressure is in the normal range.
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When a cardiac defect causes mixing of arterial and venous blood in the right side of the heart, the nurse might expect to find:
a. Cyanosis. b. Signs of pulmonary congestion. c. Increased oxygenation of the tissues. d. Diuresis.
In planning the care of a patient who has hyperthyroidism, the nurse has identified the nursing diagnosis of altered nutrition: less than body requirements. What intervention is the best response to this diagnosis?
A) Arrange for the patient to be assessed for the possible use of enteral nutrition. B) Provide the patient with a low-fat, high-protein diet. C) Provide several small meals each day for the patient. D) Teach the patient to eat each meal slowly and methodically.
A narrative account of the nurse's experiences and feelings towards those experiences may be called:
a. a professional practice reflective journal. b. a log. c. a diary. d. all of the above.