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
Doubling the dose of warfarin if a dose is missed is incorrect because it can lead to an increased risk of bleeding. Warfarin is an anticoagulant, and maintaining a consistent blood level is crucial to avoid complications. Doubling the dose can cause the blood to become too thin, leading to severe bleeding events.
Choice B rationale
Using an electric razor while on warfarin is correct because it helps prevent cuts and bleeding. Warfarin increases the risk of bleeding, and using an electric razor reduces the chance of nicks and cuts that can occur with a traditional razor.
Choice C rationale
Increasing fiber intake to reduce constipation is incorrect because warfarin does not typically cause constipation. Fiber intake is generally recommended for overall digestive health, but it is not specifically related to warfarin use.
Choice D rationale
Mild nosebleeds are not common during initial treatment with warfarin. Nosebleeds can indicate that the blood is too thin, which is a sign of over-anticoagulation and requires medical attention.
Correct Answer is D
Explanation
Choice A rationale
The SA node sending an electrical signal greater than 100/min describes sinus tachycardia, not atrial fibrillation. In atrial fibrillation, the issue is not with the SA node but with the atria’s chaotic electrical activity.
Choice B rationale
An early electrical signal occurring before the expected SA node signal describes a premature atrial contraction (PAC), not atrial fibrillation. PACs are isolated events, whereas atrial fibrillation involves sustained irregular electrical activity.
Choice C rationale
Slow electrical transmission through the AV node describes a heart block, not atrial fibrillation. In atrial fibrillation, the problem is with the atria’s rapid and irregular electrical signals, not the AV node’s conduction speed.
Choice D rationale
Atrial fibrillation is characterized by rapid, chaotic, and irregular electrical signals in the atria. This leads to an irregular and often rapid heart rate, causing symptoms like dizziness and palpitations. .