A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?

Reference Range

Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]

Hemoglobin level increased to 12 g/dL (7.45 mmol/L).

Reports of increased energy levels and decreased fatigue.

Food diary shows increased consumption of iron-rich foods.

Takes concurrent iron therapy without adverse effects.

Answer and Explanation

The Correct Answer is A

A: The primary therapeutic effect of epoetin alfa is to stimulate erythropoiesis, leading to an increase in hemoglobin levels. An increase to 12 g/dL demonstrates that the medication is effectively treating the anemia caused by CKD. Monitoring hemoglobin levels is the most objective and reliable indicator of the medication’s effectiveness.

B: While these subjective improvements can indicate an overall improvement in anemia-related symptoms, they are not the best or most definitive measure of the medication's effectiveness. Objective data, such as hemoglobin levels, provide more concrete evidence.

C: Increased consumption of iron-rich foods is beneficial for clients with anemia, but it is not a direct indicator of the effectiveness of epoetin alfa. Dietary changes can support overall health but do not provide evidence of the medication's impact on hemoglobin levels.

D: Taking concurrent iron therapy is common for clients receiving epoetin alfa, as iron is necessary for the production of red blood cells. However, the absence of adverse effects does not directly indicate the effectiveness of epoetin alfa in increasing hemoglobin levels.

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Free Nursing Study Resources

Correct Answer is D

No explanation

A. Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans. B. Advise the client that the healthcare provider needs to be made aware of her current diet. C. Commend the client for her healthy lifestyle and encourage her to continue her current diet habits. D. Confirm that her diet choices will help the medication be more effective in preventing blood clots.

Correct Answer is B

Explanation

Choice A rationale: this is not an appropriate response because while it may reduce the intake of vitamin K, suddenly changing the client's diet drastically may not be necessary. It is essential for the healthcare provider to make any necessary adjustments to the medication based on the client's diet.

Choice B rationale: Warfarin is an anticoagulant medication that works by inhibiting the formation of blood clots. It interacts with vitamin K, which plays a crucial role in the blood clotting process. Leafy green vegetables are rich in vitamin K, and their consumption can affect the effectiveness of warfarin. The nurse should advise the client to inform her healthcare provider about her vegetarian diet and the regular consumption of leafy green vegetables. The healthcare provider will then be able to adjust the warfarin dosage accordingly to ensure that the client receives the appropriate and consistent level of anticoagulation.

Choice C rationale: while a vegetarian diet can be healthy, the specific concern here is the potential impact of vitamin K-rich foods on warfarin therapy. It's essential to address this potential interaction rather than focusing solely on the overall healthy lifestyle.

Choice D rationale: Consuming large amounts of leafy green vegetables and vitamin K-rich foods may actually reduce the effectiveness of warfarin, leading to a decreased ability to prevent blood clots. Therefore, it is crucial to consult with the healthcare provider to manage the dosage appropriately.

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A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

After receiving five doses of filgrastim, the nurse notes that the client's white blood cell count has increased from 2,500/mm3 (2.5 x 109/L) to 5,000/mm3 (5 x 10°/L). Which action should the nurse implement? White Blood Cell (WBC) [Reference Range: 5000 to 10,000/mm3 (5 to 10 x 109/L)]

Correct Answer is D

A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

Correct Answer is B

Explanation

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A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective? Reference Range Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]

A client with anemia secondary to chronic kidney disease (CKD) started a prescription for epoetin alfa two months ago. Which client finding best indicates that the medication is effective?

Reference Range

Hemoglobin (Hgb) [Reference Range: Male: 14 to 18 g/dL (8.7 to 11.2 mmol/L)]