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","C","E"]
Explanation
Choice A rationale
A heart rate of 110/min and regular is not an immediate concern in this context. Tachycardia can occur due to various reasons, including anxiety or pain, and does not require immediate follow-up.
Choice B rationale
Oxygen saturation of 95-96% is within the normal range and does not require immediate follow-up.
Choice C rationale
Subcutaneous emphysema requires immediate follow-up because it indicates air leakage into the subcutaneous tissue, which can be a sign of pneumothorax or other complications.
Choice D rationale
A trachea that is midline does not require immediate follow-up as it indicates there is no mediastinal shift.
Choice E rationale
A dry puncture site does not require immediate follow-up as it indicates there is no ongoing issue at the insertion site. .
Correct Answer is D
Explanation
Choice A rationale
Reviewing laboratory test results for low hemoglobin is important for monitoring anemia, which can be a side effect of radiation therapy. However, it is not the most immediate action to address the specific side effects of radiation therapy to the lung, such as xerostomia (dry mouth) and skin reactions.
Choice B rationale
Assessing the skin for erythema is important as radiation therapy can cause skin reactions, including redness and irritation. However, this action does not directly address the management of xerostomia, which is a common side effect of radiation therapy to the head and neck areas.
Choice C rationale
Monitoring the client for signs of fatigue is essential as fatigue is a common side effect of radiation therapy. However, this action does not specifically address the management of xerostomia, which requires targeted oral care.
Choice D rationale
Providing oral care to manage xerostomia is the correct action. Xerostomia, or dry mouth, is a common side effect of radiation therapy, especially when the head and neck are involved. Oral care helps to alleviate discomfort, prevent infections, and maintain oral health.