Nursing Interventions for Patient Receiving Subcutaneous Injections of Epoetin Alfa (Procrit)

PHARMACOLOGY
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Nursing interventions
The essential nursing interventions for a 66-year-old patient receiving subcutaneous injections of epoetin alfa (Procrit) three times weekly include assessing for contraindications or cautions, performing a physical assessment to establish a baseline before and during therapy, monitoring vital signs and laboratory tests, assessing neurological status and respirations, auscultating lung sounds, monitoring access lines for clotting, evaluating iron stores periodically, monitoring blood pressure, maintaining seizure precautions, providing comfort measures, offering support and encouragement, and providing thorough patient education.
When assessing for contraindications or cautions, it is imperative to ascertain whether the patient has any documented allergies to any drug component to mitigate the risk of hypersensitivity reactions, exacerbation of severe hypertension, or potential adverse effects on the fetus in cases of lactation (Patel & Patel, 2023). Notably, these medications warrant cautious use in patients with anemia and normal renal function to prevent a rebound decrease in normal erythropoietin production and in patients with cancer undergoing antineoplastic chemotherapy and receiving drugs to increase hematocrit. Madeddu et al. (2018) attribute this to the potential for rapid tumor progression if hemoglobin levels exceed established guidelines.
During the physical assessment, the nurse should assess the patient's neurological status, including affect, orientation, and muscle strength, to identify possible adverse CNS effects (Lima et al., 2022). Sapra et al. (2022) further note that monitoring the patient's vital signs, including pulse and blood pressure, for changes and assessing the patient's cardiovascular status to identify possible CV effects is vital. The nurse should also inspect the patient's lower extremities for evidence of edema, which could indicate a change in CV function (Wisconsin Technical College System, 2021). The nurse should assess the patient's respirations and auscultate the patient's lung sounds for adventitious breath sounds to detect changes in CV function (Zimmerman & Williams, 2019).
The nurse analyzes laboratory test outcomes, such as renal function tests, complete blood count, hematocrit, iron concentration, transferrin, and electrolyte levels. This evaluation is crucial for evaluating the efficacy of therapy and maintaining a hemoglobin level below 11 g/dL (Gounden & Jialal, 2019). Understanding the relationships between hematological test results and nursing diagnoses is also paramount.
The nurse should implement various comfort measures to ensure the patient tolerates drug effects. These include offering small, frequent meals to alleviate nausea and vomiting, ensuring ready access to bathroom facilities in case of diarrhea, and providing analgesia for headaches or arthralgia (Davis, 2020). In addition, the nurse should offer emotional support and encouragement to assist ...