A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa.
Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
The hematocrit (Hct).
The erythrocyte sedimentation rate (ESR).
The platelet count.
The leukocyte count.
The Correct Answer is A
Choice A rationale
The hematocrit (Hct). This statement is correct. Epoetin alfa is used to treat anemia by stimulating the production of red blood cells. An increase in hematocrit levels indicates a therapeutic effect of the medication, as it reflects an increase in the proportion of red blood cells in the blood.
Choice B rationale
The erythrocyte sedimentation rate (ESR). This statement is incorrect. The ESR is a non- specific marker of inflammation and is not used to monitor the therapeutic effect of epoetin alfa. It does not provide information about red blood cell production or anemia.
Choice C rationale
The platelet count. This statement is incorrect. The platelet count measures the number of platelets in the blood, which are involved in clotting. It is not affected by epoetin alfa therapy and does not indicate the therapeutic effect of the medication.
Choice D rationale
The leukocyte count. This statement is incorrect. The leukocyte count measures the number of white blood cells in the blood, which are involved in the immune response. It is not affected by epoetin alfa therapy and does not indicate the therapeutic effect of the medication.
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Correct Answer is B
Explanation
Choice A rationale
Asking appropriate questions about suctioning indicates interest and understanding but does not demonstrate the ability to perform the procedure.
Choice B rationale
Performing the procedure independently shows that the partner has the necessary skills and confidence to care for the client at home.
Choice C rationale
Attending a class about tracheostomy care is beneficial but does not demonstrate the ability to perform the procedure independently.
Choice D rationale
Verbalizing all steps in the procedure indicates knowledge but does not demonstrate the practical ability to perform the procedure.
Correct Answer is C
Explanation
Choice A rationale
Take temperature weekly. This statement is incorrect. Clients with neutropenia should monitor their temperature daily, not weekly, because they are at high risk for infections. A fever can be an early sign of infection, and prompt detection is crucial for timely treatment.
Choice B rationale
Perform mild exercise, such as gardening. This statement is incorrect. While mild exercise can be beneficial, activities like gardening can expose neutropenic clients to soil and plants that may harbor bacteria and fungi, increasing the risk of infection.
Choice C rationale
Avoid crowds. This statement is correct. Neutropenic clients are highly susceptible to infections due to their weakened immune systems. Avoiding crowded places reduces the risk of exposure to pathogens that can cause infections.
Choice D rationale
Eat plenty of fresh fruits and vegetables. This statement is incorrect. While fresh fruits and vegetables are generally healthy, they can harbor bacteria and other pathogens that pose a risk for neutropenic individuals. It is often recommended that neutropenic clients eat cooked or canned fruits and vegetables instead.