Epoetin Alfa

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Tarang Patel
DNP-NA,RN,CCRN, RPh
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Outline

Overview

  1. Colony-stimulating factors
    1. Two types
      1. Epoetin Alfa
        1. Increases red blood cells
        2. Mechanism of action
          1. Epoetin Alfa acts like erythropoietin (a factor usually produced by the kidneys when RBC’s are low)
          2. Stimulates the bone marrow to produce RBC’s
        3.  Indications
          1. Anemia caused by Chronic Kidney Failure
          2. Patient with HIV
          3. Patients recieving chemotherapy
      2. Filigrastim and Sargramostim
        1. Increases white blood cells

Nursing Points

General

  1. Epoetin Alfa is can be prescribed for patients who are anemic to help stimulate their RBC production.

Assessment

  1. Assess for side effects
    1. Headache
    2. High blood pressure
    3. Joint pain
    4. Blood clotts
      1. DVT- tenderness, redness, warmth of skin in arms or legs
      2. Pulmonary embolism – short of breath, cough that brings up blood
      3. Stroke- difficulty speaking, weakness numbness in arms or legs
    5. Skin rashes (if allergic)

Therapeutic Management

  1. Administration
    1. Given as IM SubQ injection
    2. Given weekly

Nursing Concepts

  1. Clotting
    1. Epoetin Alfa can increase a patients risk of blood clots forming.
  2. Pharmacology
    1. Epoetin Alfa is a medication that is prescribed to help increase a RBC’s

Patient Education

  1. Patients may be prescribed to give doses of Epoetin Alfa at home so will need to be educated on proper administration
  2. Patients should be informed to contact their doctor if their are any signs of having a blood clot.

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Transcript

So, in this video, we gonna cover the colony-stimulating factors. And, specifically, we gonna cover the Epoetin Alfa. So, there are two types of colony-stimulating factors; one is Epoetin Alfa and another one is Filigrastim and Sargramostim. This one is for RBCs, that means red blood cells. This one is for white blood cells. So whenever you give this one, Epoetin Alfa to patient, it increases the red blood cells count and this one is, are used for, use to increase the white blood cell counts.

Let’s talk a little bit more about the Epoetin Alfa. So, whenever in our body there’s a low red blood cells, what happens, is kidney is a really important organ, it senses the low red blood cells in our body and it releases what’s called erythropoietin. Now, this factor will go to the bone marrow and tell bone marrow “Hey, we have a low red blood cells. We need to produce more.” So, the bone marrow will produce more RBCs. Now, what happens if someone have chronic kidney disease (CKD)? What is someone has kidney failure? What if someone doesn’t have kidney at all? No kidney. What will happen? Kidney cannot, there’s no kidney, or kidney disease cannot sense the low red blood cells. Then, the bone marrow will not be able to produce more red blood cells. In that case, we give this Epoetin Alfa and Epoetin Alfa will stimulate the bone marrow instead of erythropoietin to increase the production of RBCs.

So, it’s basically given for patients who are chronic kidney patient and they have low red blood cells. Like for example, for the treatment of anemia. It could be associated with anything. The patient can get anemic if they have kidney problem or some other reasons as well. So, we need, we can use this epoetin alfa to increase the red blood cells count and for the treatment of anemia. Anemia caused by the Chronic Kidney failure, as we talked. And a patient with HIV and receiving anti viral medication. And the reason they didn’t give this medication for the patient who’s receiving anti-viral medication, is most of the antiviral medication will cause the low red blood cell production, that’s one of their side effects, and in order to overcome this side effect, the patient will be on Epoetin Alfa to increase their red blood cells. And also, in patients who’s receiving chemotherapy. The chemotherapy decreases the white cells count, red cells count, split list. So, to increase the red blood cells to a patient who’s receiving chemotherapy, they’ll be put them on, they’ll be receiving Epoetin alfa at the same time to maintain the red blood cells count.

Alright, and the side effects for this medication, Epoetin alfa is headache, high blood pressure, it can cause a joint pain, and skin rashes. Mostly skin rashes, because they are allergic to it, they have some kind of reaction to this medication. Mostly, this medication came as an injection either in IM or SUBQ and it’s given like every week. It’s not like a daily medication through the injection. In some video, sometimes they ask this questions in NCLEX. It’s truly a good drug to know, as well, if you’re working on some floor where they have, they’re doing like a kidney transplant, like that procedure and the patient will be on this medication very often. This is a short video about epoetin alfa.

If you have any questions about this medication, feel free to ask us and thanks for watching it. Thank you.

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Exam 4

Concepts Covered:

  • Shock
  • Shock
  • Acute & Chronic Renal Disorders
  • Documentation and Communication
  • Preoperative Nursing
  • Factors Influencing Community Health
  • Immunological Disorders
  • Peripheral Nervous System Disorders
  • Studying
  • Oncology Disorders
  • Intraoperative Nursing
  • Noninfectious Respiratory Disorder
  • Urinary Disorders
  • Vascular Disorders
  • Renal Disorders
  • Hematologic Disorders
  • Medication Administration
  • Cardiac Disorders
  • Postoperative Nursing
  • Disorders of the Thyroid & Parathyroid Glands
  • Disorders of Pancreas
  • Disorders of the Posterior Pituitary Gland
  • Central Nervous System Disorders – Spinal Cord
  • Renal and Urinary Disorders
  • Lower GI Disorders
  • Fundamentals of Emergency Nursing
  • Perioperative Nursing Roles
  • Musculoskeletal Trauma
  • Gastrointestinal
  • Renal
  • Respiratory Disorders

Study Plan Lessons

02.14 Shock Stages for CCRN Review
02.15 Hypovolemic Shock for CCRN Review
02.16 Cardiogenic Shock for CCRN Review
02.17 Septic Shock for CCRN Review
Acute Kidney Injury Case Study (60 min)
Acute Renal (Kidney) Module Intro
Admissions, Discharges, and Transfers
Age and Culturally Appropriate Health Assessment Techniques for Certified Perioperative Nurse (CNOR)
AIDS Case Study (45 min)
Allergic Reactions and Anaphylaxis for Certified Emergency Nursing (CEN)
Assessment for Myasthenic Crisis Nursing Mnemonic (BRISH)
Biopsy
Blood Salvage Transfusion Anticipation for Certified Perioperative Nurse (CNOR)
Cardiogenic Shock and Obstructive Shock for Certified Emergency Nursing (CEN)
Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)
Causes of Anaphylaxis Nursing Mnemonic (Many Boys Love Food)
Causes of Dyspnea Nursing Mnemonic (The 6 P’s)
Causes of Renal Calculi Nursing Mnemonic (Patients Complain of Pain and Difficulty Urinating)
Chemotherapy Patients
Chronic Kidney Disease (CKD) Case Study (45 min)
Chronic Renal (Kidney) Module Intro
Circulatory Checks (5 P’s) Nursing Mnemonic (The 5 P’s)
Continuous Renal Replacement Therapy (CRRT, dialysis)
Diagnostic Criteria for Lupus Nursing Mnemonic (SOAP BRAIN MD)
Dialysis & Other Renal Points
End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)
Epoetin (Epogen) Nursing Considerations
Epinephrine (EpiPen) Nursing Considerations
Epoetin Alfa
Erythrocyte Sedimentation Rate (ESR) Lab Values
Fluid Volume Overload
Genitourinary (GU) Assessment
Genitourinary Course Introduction
Genitourinary Trauma for Certified Emergency Nursing (CEN)
Genitourinary Infections for Certified Emergency Nursing (CEN)
Hemodialysis (Renal Dialysis)
Hematology/Oncology/Immunology Course Introduction
Hematology Module Intro
Hemorrhage Nursing Interventions for Certified Perioperative Nurse (CNOR)
Hypercalcemia – Signs and Symptoms Nursing Mnemonic (GROANS, MOANS, BONES, STONES, OVERTONES)
Hyperglycemia for Progressive Care Certified Nurse (PCCN)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (FRIED)
Hypernatremia – Signs and Symptoms 2 Nursing Mnemonic (SWINE)
Hypernatremia – Signs and Symptoms 3 Nursing Mnemonic (SALT)
Hypocalcemia – Definition, Signs and Symptoms Nursing Mnemonic (CATS)
Hypoglycemia
Hypoglycemia – Signs and Symptoms Nursing Mnemonic (TIRED)
Hypoglycemia for Progressive Care Certified Nurse (PCCN)
Hypoglycemia Management Nursing Mnemonic (Cool and Clammy – Give ‘Em Candy)
Hypoglycemia symptoms Nursing Mnemonic (DIRE)
Hypokalemia – Signs and Symptoms Nursing Mnemonic (6 L’s)
Hyponatremia- Definition, Signs and Symptoms Nursing Mnemonic (SALT LOSS)
Immunocompromise (HIV and AIDS, Oncology and Chemotherapy, Transplant Patient) for Certified Emergency Nursing (CEN)
Immunology Module Intro
Implant Preparation for Certified Perioperative Nurse (CNOR)
Implant Records and Tracking for Certified Perioperative Nurse (CNOR)
Implant Verification and Availability for Certified Perioperative Nurse (CNOR)
Intake and Output (I&O)
Intrarenal Causes of Acute Kidney Injury Nursing Mnemonic (TONIC)
Kidney Cancer
Management of Glomerulonephritis Nursing Mnemonic (Please Help Deliver Diuretics)
Metabolic Acidosis (interpretation and nursing diagnosis)
Metabolic/Endocrine Course Introduction
Multiple Sclerosis Symptoms Nursing Mnemonic (DEMYELINATION)
Nephrotic Syndrome Case Study (Peds) (45 min)
Neurogenic Shock for Certified Emergency Nursing (CEN)
Neurological Disorders (Multiple Sclerosis, Myasthenia Gravis, Guillain-Barré Syndrome) for Certified Emergency Nursing (CEN)
Nursing Care and Pathophysiology for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care and Pathophysiology for Anaphylaxis
Nursing Care and Pathophysiology for Anemia
Nursing Care and Pathophysiology for Cardiogenic Shock
Nursing Care and Pathophysiology for Distributive Shock
Nursing Care and Pathophysiology for Hypovolemic Shock
Nursing Care and Pathophysiology for Multiple Sclerosis (MS)
Nursing Care and Pathophysiology for Myasthenia Gravis
Nursing Care and Pathophysiology for Rheumatoid Arthritis (RA)
Nursing Care and Pathophysiology for Scleroderma
Nursing Care and Pathophysiology for Sepsis
Nursing Care and Pathophysiology of Acute Kidney (Renal) Injury (AKI)
Nursing Care and Pathophysiology of Chronic Kidney (Renal) Disease (CKD)
Nursing Care and Pathophysiology of Glomerulonephritis
Nursing Care and Pathophysiology of Nephrotic Syndrome
Nursing Care and Pathophysiology of Osteoarthritis (OA)
Nursing Care and Pathophysiology of Renal Calculi (Kidney Stones)
Nursing Care and Pathophysiology of Urinary Tract Infection (UTI)
Nursing Care Plan (NCP) for Acquired Immune Deficiency Syndrome (AIDS)
Nursing Care Plan (NCP) for Acute Kidney Injury
Nursing Care Plan (NCP) for Anemia
Nursing Care Plan (NCP) for Anaphylaxis
Nursing Care Plan (NCP) for Cardiogenic Shock
Nursing Care Plan (NCP) for Chronic Kidney Disease
Nursing Care Plan (NCP) for Glomerulonephritis
Nursing Care Plan (NCP) for Kidney Cancer
Nursing Care Plan (NCP) for Multiple Sclerosis (MS)
Nursing Care Plan (NCP) for Myasthenia Gravis (MG)
Nursing Care Plan (NCP) for Nephrotic Syndrome
Nursing Care Plan (NCP) for Osteoarthritis (OA), Degenerative Joint Disease
Nursing Care Plan (NCP) for Renal Calculi
Nursing Care Plan (NCP) for Rheumatoid Arthritis (RA)
Nursing Care Plan (NCP) for Rhabdomyolysis
Nursing Care Plan (NCP) for Systemic Lupus Erythematosus (SLE)
Nursing Care Plan for Distributive Shock
Nursing Care Plan for Scleroderma
Nursing Case Study for Acute Kidney Injury
Nursing Case Study for Cardiogenic Shock
Nursing Case Study for Rheumatoid Arthritis
Obstruction for Certified Emergency Nursing (CEN)
Obstructions for Certified Emergency Nursing (CEN)
Patient and Healthcare Team Safety (Disasters, Environmental Hazards) for Certified Perioperative Nurse (CNOR)
Patient Positioning
Patient Positioning (Performance) for Certified Perioperative Nurse (CNOR)
Peritoneal Dialysis (PD)
Protein in Urine Lab Values
Renal (Kidney) Failure Labs
Renal Failure for Certified Emergency Nursing (CEN)
Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)
Rheumatoid Arthritis Assessment Nursing Mnemonic (RHEUMATOID)
Scleroderma Symptoms Nursing Mnemonic (CREST)
Sepsis Concept Map
Sepsis for Certified Emergency Nursing (CEN)
Sepsis for Progressive Care Certified Nurse (PCCN)
Sepsis Labs
Septic Shock (Sepsis) Case Study (45 min)
Shock
Shock – Signs and symptoms Nursing Mnemonic (TV SPARC CUBE)
Shock Module Intro
Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)
Signs of Osteoarthritis Nursing Mnemonic (OSTEO)
Symptoms of Nephrotic Syndrome Nursing Mnemonic (NAPHROTIC)
Systemic Lupus Erythematosus (SLE)
Vitamin D Lab Values
Who Needs Dialysis Nursing Mnemonic (AEIOU)
06.01 Organ Failure, Dysfunction & Trauma for CCRN Review
09.01 Acute Renal Failure Overview for CCRN Review
09.03 Acute Renal (Pre-Renal vs Renal) Failure for CCRN Review
09.05 Chronic Renal Failure for CCRN Review
ABG (Arterial Blood Gas) Interpretation-The Basics
ABGs Nursing Normal Lab Values