Generic Dosage Mechanism

Name/ Trade Date Classifica- And Of Indication Contraindi- Adverse Nursing

Name/ Ordered tion Frequency Action cation Reaction Responsiblity
Form of
Medication

Epoetin Haematop 500 units Mimics effect of Treatment of -Poorly CNS: -Before starting
Beta oietic subcutane erythropoietin. anemia controlled Headache, therapy,
evaluate
(Recormon) drugs ous twice Functions as associated with HTN seizures,
patient’s iron
a week growth factor, chronic renal -Not to be paresthesia, status. Patient
Peak: 5-24 enhancing RBC failure on or not used if the fatigue, should receive
hrs. production on dialysis and indication is dizziness, adequate iron
malignancy on for increasing asthenia supplementation
or not on the yield of CV: beginning no
later than when
chemotherapy autologous hypertension, epoetin
blood if mth edema, treatment starts
preceding increased and continuing
treatment of clotting of throughout
patient arteriovenous therapy. Patient
also may need
suffered MI, grafts
vitamin B12 and
stroke, EENT: folic acid
unstable Pharyngitis -Monitor BP
angina G.I: before therapy.
pectoris, or at Nausea, Most patients
risk of vomiting, with chronic
renal
DVT,history abdominal pain failure have
of Metabolic: hypertension. BP
thromboembo Hyperuricemia, may
lic disease. hyperkalimia, Increase,
hyperphosphate especially when
hematocrit
mia
Respiratory: increases in the
Cough, early part of
therapy
shortness of -institute diet
breath restrictions or
Skin : drug therapy to
Rash, infection control BP
site reactions, -monitor
hemoglobin level
urticaria
twice weekly
Other: pyrexia until it stabilizes
in the target
range (10 to 12
g/dl for most
patients) and
maintenance
dose is
established, then
continue to
monitor at
regular intervals.
Resume twice
weekly testing
following any
dosage
adjustments
-reduce dosage
in patients who
have an increase
in hemoglobin
level of more
than 1 g/dl in any
2 week period
-monitor blood
counts; elevated
hematocrit may
cause excessive
clotting
-patient may
need additional
heparin to
prevent clotting
treatments
-evaluate patient
who experiences
a lack or loss of
effect for pure
red cell aplasia
Patient teaching
-inform patient
that pain or
discomfort in
limbs (long
bones) and
pelvis, and
coldness and
sweating may
occur after
injection (usually
within 2 hours)
symptoms may
last for 12 hours
and then
disappear
-advise patient to
avoid driving or
operating heavy
machinery at
start of therapy.
There may be a
relationship
between too
rapid increase
hematocrit and
seizures
-Tell patient to
monitor BP at
home and
 adhere
dietary
restrictions

Nursing Problem: Injury risk for (loss of vascular access)

Assessment Diagnosis Inference Planning Intervention Rationale Evaluation

Independent
Not Injury risk Loss of vascular After 4 hours of Evaluate reports of May Goal met
applicable; for (loss of access is inability duty patient will pain, indicate Patient is able
presence of vascular to administer be able to numbness/tingling ; blood to maintain
signs and access) therapy or maintain patent note extremity supply patent
symptoms related to obtaining blood vascular access swelling distal to vascular
establishes clotting for testing in the access access.
an actual vascular system
diagnosis of Avoid trauma to Decreases
the shunt Reference: shunt: e.g handle the risk of
http://medical- tubing gently, clotting /
dictionary.thefreedi maintain cannula disconnecti
ctionary.com/vascul alignment. Limit on
ar+access activity of extremity.
Avoid taking BP or
drawing blood
supplies in shunt
extremity. Instruct
patient not to sleep on
side with shunt or
carry packages,
books, purse of the
affected extremity

Collaborative:
Administer medication Infused on
as indicated, e.g: arterial side
Heparin (low dose) of filter to
prevent
clotting in
the filter
without
systemic
side effects