Clinical context A 68-year-old with stage 4 chronic kidney disease has hemoglobin 8.7 g/dL, controlled blood pressure, adequate iron stores, fatigue, and no current indication for urgent transfusion; darbepoetin alfa is prescribed. Which actions are appropriate when administering darbepoetin alfa for anemia of chronic kidney disease? Select exactly 4 responses.
Select All That Apply
Choose your responses, then check the answer.
Explanation
ESA safety includes blood-pressure control, iron evaluation, close hemoglobin monitoring, and the lowest effective dose; higher hemoglobin targets increase cardiovascular and thrombotic risk.
Quick answer Use lowest effective ESA exposure with iron and pressure surveillance.
Why this is correct Aranesp is contraindicated in uncontrolled hypertension, requires iron and hemoglobin monitoring, and should not be used as immediate transfusion replacement.
Easy analogy or mental picture Think of medication safety as a control panel: identify the dangerous signal, change the correct control, and verify the response.
Memory hook Cue, action, response, reassessment.
NCLEX decision rule Choose the action that prevents the most immediate medication-related harm while preserving the continuing indication.
Why the other choices are wrong Options that delay escalation, ignore a contraindication, or change therapy without authorization do not close the safety loop.
References
1DailyMed: ARANESP (darbepoetin alfa)CKD anemia, iron evaluation, hemoglobin and blood-pressure monitoring, and cardiovascular or thrombotic risk
Clinical contextA 68-year-old with stage 4 chronic kidney disease has hemoglobin 8.7 g/dL, controlled blood pressure, adequate iron stores, fatigue, and no current indication for urgent transfusion; darbepoetin alfa is prescribed.