Epogen Pointers: What You Need to Become an Excellent Nurse

Epogen Pointers for Excellent Nursing

Anemia is a condition characterized by the inadequacy of red blood cells, components that deliver oxygen to various parts of the body. This disorder is hallmarked by symptoms such as fatigue, dizziness, shortness of breath, tachycardia and pallor.

To cure this illness, doctors usually prescribe Epogen. As such, this medication is commonly found in the NCLEX.

Indications for Use

Generically known as Epoietin Alfa, Epogen is categorized as a recombinant human erythropoietin. It boosts the production of glycoproteins in the kidneys, which then increases the synthesis of red blood cells in the bone marrow.

Epogen is prescribed in patients with anemia related to the following:

  • Chronic renal failure, especially those on dialysis
  • Renal failure in ages 1-16 years old, requiring dialysis
  • Zidovudine therapy for HIV-AIDS
  • Chemotherapy

Apart from anemia treatment, Epogen is also used to reduce allogenic blood transfusions in patients undergoing surgery. Other indications included pruritus secondary to renal failure, myelodysplastic syndrome and chronic inflammation due to rheumatoid arthritis.

symptoms of anemiaNursing Considerations

Assessment is an integral part of Epogen therapy. As such, make sure to take the patient’s history and note for hypersensitivity to mammalian cell-derived products/human albumin, uncontrolled hypertension and lactation.

As for physical examination, obtain pertinent information such as the patient’s vital signs, affect, reflexes and urinary output prior to administration. Ensure that lab exams such as CBC, Hematocrit, Serum iron, electrolytes and renal function tests are extracted accordingly.

NCLEX Nursing Interventions

When preparing Epogen, remember to gently mix the solution. Do not shake the vial, as it might denature the glycoprotein. Additionally, use only one dose per vial and avoid re-entering it. Discard the vial after use, even if there is still something remaining in the container.

Avoid giving Epogen with any other drug or medication.

Epogen should be administered thrice weekly. Intravenous or subcutaneous are the preferred routes, though it can be given directly to the venous access line of dialysis patients. Prior and after administration, evaluate the access line for signs of clotting.

Make sure that the patient’s Hematocrit is checked prior to Epogen therapy. This will determine the accurate dosage for the client. Additionally, check the patient’s serum iron to evaluate if supplemental iron is needed.

Remember to place patients receiving Epogen on seizure precaution, as it can occur with the drug.

Important NCLEX Teaching Points

As Epogen needs to be given three times a week, create an administration schedule for the patient so that he can comply. Additionally, create a schedule of blood extraction tests handy, so the appropriate dosage can be determined.

As for side effects, inform the patient that these are normal:

  • Headache
  • Dizziness
  • Joint pain
  • Fatigue
  • Nausea and vomiting
  • Diarrhea

The following, however, are warning signs that should be reported to the doctor or the nurse:

  • Difficulty of breathing
  • Tingling/numbness
  • Chest pain
  • Severe headache
  • Seizures

Knowing the following facts will definitely make you an effective nurse. Ensure your patient’s health and safety by studying the practice NCLEX questions at nclexpreceptor.com.

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Know the Important Details of Oxytocin

Oxytocin Important Details

Obstetrics and Gynecology is considered difficult by many NCLEX takers. But since it is a major subject, questions about this field are sure to appear in your forthcoming test. Increase your chances of passing the exam by familiarizing yourself with one of Ob-Gyne’s most common medications: Oxytocin.


Indications for Use

Also known by the brand name Pitocin, it is a synthetic hormone similar to the substance produced by the hypothalamus. Oxytocin works by stimulating the uterus, as such it is used to jumpstart labor – and continue it along the way.

Apart from stimulating labor, Oxytocin is used to control post-partum bleeding. It is also indicated in the management of incomplete or inevitable abortion.

Pitocin also causes the contraction of lacteal glands. As such, it is used to improve milk secretion in breastfeeding mothers.

Nursing Considerations

While Oxytocin can help stimulate labor, an aspiring nurse like you should be mindful about assessing the patient receiving the said drug. History-taking is vital, as cephalopelvic disproportion, unfavorable fetal presentation/position, previous Caesarian section and toxemia are contraindications to the use of Pitocin.

As a nurse, it is also important to monitor the patient’s uterine contraction and uterine tone. Other aspects that should be included in the assessment are the patient’s vital signs, reflexes, breath sounds and urinary output. Lab tests such as CBC and coagulation studies should be evaluated in patients receiving Oxytocin as well.

NCLEX Nursing Interventions

Since Oxytocin works by stimulating the uterus, the nurse should be vigilant in monitoring uterine tone and uterine contraction. Maternal BP should be checked periodically as well. As a nurse, it is your responsibility to discontinue the drug and alert the physician if you notice signs of uterine spasm/hyperactivity or an impending hypertensive emergency (characterized by sudden headache, elevated BP and stiff neck, to name a few.)

Apart from the mother, the fetus (specifically his heart rate) should be monitored while the patient undergoes Oxytocin therapy. In case of rapid changes in FHT, the solution should be discontinued and the patient should be placed on her side to avoid fetal anoxia.

Oxytocin also has marked effects on the baby. After delivery, the nurse should check the neonate for the onset of jaundice or retinal hemorrhage.

Important NCLEX Teaching Points

Although patients on Oxytocin are usually in hospitals and can be monitored regularly, it is your duty as a nurse to inform the client about the actions and effects of Oxytocin.

Severe and sudden headache is an adverse side effect of Oxytocin. Instruct patient to report such onset to you or other healthcare providers, ASAP.


Ob-Gyne NCLEX questions might be hard, but you can ace them all simply by reviewing this study guide about Oxytocin. Learn more about other commonly asked drugs by going through the practice NCLEX questions at nclexpreceptor.com.

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Lithium Carbonate: What You Need to Know

Lithium Carbonate Must-Knows

The NCLEX consists of four core topics, with Physiological Integrity as one of them. Under this section is ‘pharmacological and parenteral therapies,’ undoubtedly one of the hardest subjects in the exam.

As such, it is important that you familiarize yourself with the common medications found in the NCLEX, one of which is Lithium Carbonate. Here are some important facts you need to know about this drug:

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Indication for Use

Lithium Carbonate is an anti-manic drug, used in the treatment of manic episodes in individuals with bipolar disorder. It is also used as a maintenance drug, in order to decrease the intensity and frequency of ensuing manic outbreaks.

Lithium Carbonate, also known by the names Eskalith, Eskalith CR, Lithobid, Lithonate and Lithotabs, works by inhibiting dopamine and norepinephrine release. Placed under Pregnancy Category D, this drug is known to cross the placenta and the milk ducts.

Lithium Toxicity

Nursing Considerations

As a nurse, you need to know that Lithium Carbonate interacts with a lot of drugs and supplements. Toxicity can occur if it is taken in conjunction with Thiazide diuretics such as Hydrochlorothiazide and Indapamide. CNS toxicity can also occur if it is taken with Carbamazepine.

Plasma Lithium Carbonate levels, on the other hand, can increase and become toxic if it taken in conjunction with NSAIDs (i.e. Ibuprofen and Meloxicam) and Indomethacin.

Prior to administering Lithium Carbonate, make sure to take the patient’s history. Note if the patient has a severe heart or kidney problem. Assess if the patient takes diuretics, or if he suffers from tartrazine hypersensitivity.

Also remember to monitor the patient’s vital signs, weight, orientation and affect prior to administering Lithium Carbonate. Check his fluid intake and output as well. Do not forget to evaluate the baseline results of the following exams: CBC, Urinalysis, ECG, Thyroid and Renal function tests.

Nursing Interventions

Because of this risk of toxicity associated with Lithium Carbonate, religiously check the serum levels of the patient, especially if he is dehydrated, debilitated, or diagnosed with heart or kidney diseases. Remember that the therapeutic level for this drug is 0.6 to 1.2 mEq/L.

The efficacy or toxicity of Lithium Carbonate depends on the patient’s salt and fluid intake. As such, instruct your client to maintain adequate salt and fluid intake, which is 2.5 to 3 liters per day.

Important Teaching Points

Nurses are patient educators, so you need to remind them of essential drug pointers, especially if they will be taking Lithium Carbonate at home.

Make sure to advise your patient to take Lithium Carbonate after meals with food or milk. Remind him about maintaining a normal salt and fluid intake for optimum effectiveness.

Inform your patient about the expected side effects of Lithium Carbonate, which are drowsiness, dizziness, GI upset, mild thirst, increased urine volume and fine hand tremor.

Most importantly, instruct your patient to coordinate with you or another healthcare provider if he experiences the signs of toxicity, which include tremor, vomiting, diarrhea, drowsiness, muscular weakness and lack of coordination.


Lithium is just one of the many medications you can expect in your forthcoming NCLEX exam. Master this drug – among many others – at NCLEXpreceptor.com’s practice NCLEX questions.

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Acyclovir Pointers: What You Need to Pass Your NCLEX Quickly

Vital Acyclovir Pointers

The first anti-viral medications were created in the 1960’s, and they were all focused on curing the herpes virus family. Fortunately, through tireless effort and monitoring – Acyclovir – one of the common NCLEX medications – was invented.

Indications for Use

Known with the brand name of Zovirax, Acyclovir is an anti-viral agent that works by inhibiting DNA replication.

Whereas antibiotics are for bacterial infections, anti-virals such as Acyclovir are prescribed for certain viral illnesses. Compared to antibiotics, anti-virals can only inhibit the development of pathogens, and not destroy them.

Acyclovir is primarily prescribed in patients suffering from a Herpes infection. They include:

  • Genital herpes
  • Herpes zoster/ Herpes simplex
  • Herpes simplex encephalitis in babies 6 months and younger
  • Mucosal/cutaneous Herpes Simplex (HSV) 1 or 2 in Immunocompromised patients
  • HSV infection following transplant
  • Disseminated eczema herpeticum

herpes zosterOther indications include Cytomegalovirus infection, infectious mononucleosis and varicella pneumonia.

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Nursing Considerations

As it has been emphasized in nursing school, assessment is the first vital step to the nursing process. Before administering Acyclovir, make sure to evaluate the patient for the presence of allergies, congestive heart failure, seizures, renal disorder and lactation.

Additionally, perform a thorough physical examination of the patient. Check the client’s vital signs, orientation, lung sounds, urinary output, skin color and presence of skin lesions. Lab exams that should be requested are kidney function tests (BUN and Creatinine.)

NCLEX Nursing Interventions

When administering systemic Acyclovir, ensure that the patient is hydrated throughout the course of the therapy. Remember that this drug is nephrotoxic, which means it can have a negative effect on the kidneys.

If administering Acyclovir topically, institute treatment as soon as the first infectious signs and symptoms appear. Additionally, don a finger cot when applying the medication.

Important NCLEX Teaching Points

For patients receiving Acyclovir therapy, instruct them to complete the prescribed dose. Emphasize that they should not go beyond the recommended dose.

Additionally, remind them that it will NOT cure the disease, but it can lessen the severity signs/symptoms. Note that even with the application of the drug during symptom-free periods, prevention of recurrence is not ensured. As such, instruct the patient to wear a rubber glove/finger cot upon topical application to prevent transmission or self-inoculation.

Remember to teach the patient about the expected side effects of the drug (systemic), which include diarrhea, headache, dizziness, loss of appetite, vomiting and nausea.

Side effects for topical Acyclovir, on the other hand, are stinging, burning, itching and rashes. If these signs become more pronounced, inform the nurse/doctor right away.

Apart from the severity of the following signs, the onset of skin rashes, urination difficulty and recurrence also warrant the notification of healthcare personnel right away.

Those receiving Acyclovir therapy (both systemic and topical) should also be reminded to abstain from sexual intercourse especially if lesions are visibly present.

Anti-virals are commonly used in hospital and home settings, so it is best if you know about this medication. Master this drug – and many other therapeutic agents – with the practice NCLEX questions at nclexpreceptor.com.

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Narcan Facts You Need to Master

Narcan NCLEX Pointers

Administering medications is the daily bread of nurses. As such, the NCLEX aims to prepare aspiring nurses for the big task that lies ahead. While the exam deals with a bevy of drugs, most questions focus on commonly-used drugs in the floor, such as Narcan.


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Indications for Use

Narcan, generically known as Naloxone Hydrochloride, is a central nervous system agent and a narcotic antagonist. It works by reversing the effects of opioids on the body, with signs that include sedation, respiratory depression and hypotension.

Because of these effects, Narcan is used to overturn respiratory depression caused by opioids such as Nalbuphine, Butorphanol, Propoxyphene and Pentazocine, to name a few. It is also used to diagnose suspected cases of opioid overdose.

Narcan is also used in reversing alcohol coma, enhancing circulation in refractory shock and treating schizophrenic/Alzheimer’s dementia.

Nursing Considerations

A good history is the foundation of effective medication administration. As such, prior to giving Narcan, make sure to perform a comprehensive history in order to detect allergy to narcotic antagonists and presence of narcotics addiction. Cardiovascular problems and lactation should be assessed in patients who you have to medicate as well.

A thorough physical examination should also be done prior to the administration of Naloxone Hydrochloride. Things you need to check are the following: vital signs, lung sounds, reflexes, pupil size and sweating.

For best results, store the drug at temperatures ranging from 59 to 86 degrees Fahrenheit. Avoid exposing it to excessive light. Additionally, make sure to use Narcan within 24 hours of opening.

NCLEX Nursing Interventions

Continuous monitoring is important in all patients taking medications, especially those prescribed with Narcan. The most important thing to remember is to ensure that the patient has an open airway. Provide artificial ventilation and vasopressor agents, and administer vasopressor agents as needed to combat narcotic overdose.


Also know that those receiving this drug might warrant repeated doses, depending on the time of the last drug administration, and the lifespan of the narcotic in the body. However, be careful in administering this drug with other medications especially if you use a Y-site. Note that it is highly incompatible with Amphotericin B Cholesteryl Complex.

If you have a patient receiving Narcan who has recently undergone a surgical or obstetrical procedure, monitor him/her for signs of profuse bleeding. Remember, use of Naloxone Hydrochloride has been associated with deranged bleeding times.

Important NCLEX Teaching Points

Health teaching is a vital role of nurses, as it helps the patient optimize the medication – and avoid any untoward adverse effects associated with it.

When administering Narcan, it is important that you tell the patient to immediately report feelings of tremulousness and profuse sweating.


NCLEX drugs might be overwhelming, but you can master them efficiently! Be able to do so by going through the NCLEX practice questions at nclexpreceptor.com.

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