Case Study - Introduction to the Hematopoietic and Lymphatic Systems
April Holiday, a 54-year-old female client, is going for her first hemodialysis today. The client is scheduled to receive hemodialysis three times weekly and is on a fluid restriction and a renal diet. The client's vital signs are T, 98° F, BP, 110/70 mm Hg; HR, 100 beats/minute; RR, 22breaths/minute. The client has no pain but states she feels very fatigued and has constipation. The nurse notes that the conjunctiva and mucous membranes are pale. The client has a pale sallow coloration of her skin. The hemoglobin is 8 g/dL and the hematocrit is 24%. The client is currently taking the following medications to help alleviate anemia: Ferrous sulfate 200 mg po three times daily, multivitamin with folic acid, B complex one daily, and epoetin alfa (Procrit) 50 units/kg/dose subcutaneously on the days of dialysis. The Procrit medication is available in 4000 units/mL, a single-dose vial. The nurse weighs the client, noting she is 50 kg. The LPN/LVN needs to provide nursing management for the client's anemia.
a. What dose of Procrit should the nurse provide the client and what are the administration considerations?
b. Explain the nursing management for the client's anemia.