Assessing hyporesponse to Epoetin alfa: an algorithm approach: case study of the anemic patient.
Nephrology nurses who manage the anemia of end-stage renal disease (ESRD) are often responsible for monitoring, assessing, and intervening to maintain hemoglobin (Hb) and hematocrit (Hct) levels within their facility target range. Consistency in anemia-related outcomes is sometimes compromised when patients exhibit hyporesponse to Epoetin alfa therapy-defined as a temporary or chronic Hb/Hct level below the target range. Early detection of hyporesponse and correction of conditions that are affecting erythrocyte development can sometimes be delayed if clinicians are unable to promptly identify a causative etiology. This article reviews a hyporesponse algorithm worksheet that nurses can use to identify the cause(s) of hyporesponse and guide clinical decision making.
Wingard
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Quality Department, Renal Care Group, Nashville, TN, USA.
D000368:Aged; D000465:Algorithms; D018798:Anemia, Iron-Deficiency / Q000188:drug therapy* / Q000209:etiology; D003663:Decision Trees; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing; D000068817:Epoetin Alfa; D004921:Erythropoietin / Q000627:therapeutic use*; D005260:Female; D006397:Hematinics / Q000627:therapeutic use*; D006400:Hematocrit; D006454:Hemoglobins / Q000378:metabolism; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009730:Nursing Assessment / Q000379:methods*; D011994:Recombinant Proteins; D006435:Renal Dialysis / Q000009:adverse effects / Q000451:nursing; D012307:Risk Factors; D017211:Treatment Failure
D006397:Hematinics; D006454:Hemoglobins; D011994:Recombinant Proteins; D004921:Erythropoietin; D000068817:Epoetin Alfa