a health care professional is caring for a patient who is about to begin taking epoetin alfa This is a topic that many people are looking for. passionistsisters.org is a channel providing useful information about learning, life, digital marketing and online courses …. it will help you have an overview and solid multi-faceted knowledge . Today, passionistsisters.org would like to introduce to you Epoetin Nursing Considerations, Side Effects, and Mechanism of Action Pharmacology for Nurses. Following along are instructions in the video below:
Righty putin alpha or epogen okay. This isnt medication syndicated for anemia. Itss therapeutic class is anti anemic and its pharmacologic class is hormone.
So let talk really quickly about how our body knows when its time to produce more red blood cells and how that really works so our blood you can really think of our blood. Is like a messenger system as our blood travels throughout our body. Its providing an tremendous amount of data to our body you know through a positive and negative feedback system.
Its its providing data to our kidneys to our brain to our lungs to everything about whats going on in the body. So you can really think of our our blood and our bloodstream is really like this data stream. This data system that passes throughout just continuously delivering millions and billions of points of data to our body.
Then leads to our body. Doing things or not doing things. And thats what we refer to as positive and negative feedback systems well red blood cell production is part of this system right as our body as our blood passes through our body.
It will eventually pass through our kidneys and in our kidneys. Thats providing so much data. There and our kidneys play a role in either initiating or stopping a lot of what goes on within our body okay so blood passes through our kidneys and within our kidneys and in our kidneys.
If our if they sense that our blood is low on oxygen. Okay. So what will happen is our kidneys will sense that our blood is low on oxygen carrying capacity our blood is low on oxygen.
What it will do is it will release erythropoietin and create ok. Erythropoietin is a hormone that tells our body. Its time to produce more red blood cells and the process of producing red blood cells is called erythropoiesis ok so what happens is this this then stimulates our bone marrow to start producing red blood cells erythropoietin is released from our kidneys that then stimulates erythropoiesis and stimulates our bone marrow to produce more red blood cells.
So thats how the process really works and in our patients who are chronically anemic. They might need assistance with this and thats why we would really give our with wheaton and other the epogen. We wouldnt really give it to a patient just has low rbcs one time or something like that we might just give them a transfusion.
A patient whos. Chronically anemic who maybe has rbcs of less than. 15 or 18.
Or so they may be a good candidate for epogen. So. Hopefully youre understanding how that kind of works.
Okay. Why our body is going to stimulate the rhythmic voices. And how epogen or a point alpha.
Is going to play a role in that what its really going to do is its going to stimulate this erythropoiesis where the patient is chronically anemic. So a couple things to keep in mind here. These anti anemic that we give our patient they can actually increase clotting right where were stimulating this red blood cell production.
Which can then lead to additional clotting. So in a patient who for example is on dialysis and possibly has a shunt. Its really really really important that we keep our our renal patients.
Shunts. Fully functioning and clear and perfusing and everything so in a patient who has a dialysis shunt. What you really need to do is you really need to assess that shunt make sure that its working really well theres two things that we really do to assess.
Shunts and assess if theyre working hopefully you know what im going to say right now. But im gonna say you need to assess for bruit and thrill okay. Whats a bruit well bruit is the sound that youre gonna hear with your stethoscope.
If you put that to the shunt and what that sound is thats blood flushing and rushing through the shunt and then theres a the thrill is the fill that youre gonna get it really feels like just rushing blood. You can actually feel it those are two good things. I remember the first time.
I heard about bruit and thrill in nursing school in my physical assessment course. I thought maybe they were bad things. But theyre actually really good things.
Thats what you want if you can assess and hear a bruit then you know that blood is flowing through that shunt if you can fill the thrill then you know that blood is flowing. We want blood to be flowing through the shunt that means. Its payton that means.
Its usable now what can happen when we give our patients ipoh. Eaten is that it can actually increase clotting and possibly clot off that shunt so we really want to assess that make sure. Its working first thing.
We do when we get to a shift thats whats what i really want you to understand and take away from this is the second you get on a shift assess that shunt right away. You dont want to wait till. Dialysis time in the morning or in the evening or if youre running dialysis on your shift.
Cb vhd or something you dont want to go and fill that halfway through the shifts. See that its clotted off and then need to call the provider at that moment and say its not working what when did it stop working. I dont know you want to assess that first thing.
This is one of those things central lines shunts these are one of the things that you assess first thing you walk into a room so you can see if its working. But before your shift. Even starts.
Were also going to initiate caesar precautions. This can actually lead to seizures and possibly cause seizure. So well initiate caesar precautions for patients who are on a poitain alpha.
Its also contraindicated in hyper or albumin hypersensitivity and we want to definitely monitor our bleeding times like we said these anti anemic s. Can decrease our bleeding times increase clotting. So we really want to be careful monitor our bleeding times and one thing to really keep in mind here.
With this is never ever shake the bile. Okay. We never want to shake the bile before we give it to our patient.
So these are really important things to keep in mind biggest thing. I want you to keep in mind is is just this whole anatomic physiologic phase. That the stimulates red blood cell erythropoiesis and what role the blood.
The kidneys and the bone marrow play in this and then why were going to be giving epogen to our patient. And how it really plays part in this biofeedback system in our body is just truly fascinating and then keeping in mind that were always assessing our dallass shunts for these patients. So the biggest things to keep in mind here.
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