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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale: Checking the capillary glucose level is not relevant to the observation of yellow skin color. Jaundice is related to liver function, not glucose levels.
Choice B rationale: Oxygen saturation measurement is not relevant to the observation of yellow skin color. It is used to assess the oxygen-carrying capacity of the blood, not liver function.
Choice C rationale: Yellow discoloration of the skin (jaundice) can be indicative of liver dysfunction or damage. Since the client takes acetaminophen for chronic pain, which is metabolized in the liver, the nurse should be concerned about potential hepatotoxicity. Reporting the findings to the healthcare provider is essential for further evaluation and management.
Choice D rationale: Reducing the medication dose is not appropriate without further evaluation and guidance from the healthcare provider. Jaundice may indicate liver dysfunction, and altering the medication without professional assessment could be unsafe.
Correct Answer is C
Explanation
A. Bedtime is the best time to take the tablet.While taking medication at bedtime can sometimes be convenient, it is not necessarily the best time for iron absorption. Iron is best absorbed on an empty stomach, and bedtime might not always align with this condition.
B. Crush the tablets and mix with pudding.Crushing enteric-coated tablets is not recommended because it destroys the coating designed to protect the stomach lining from irritation and to ensure the iron is released in the intestine where it is best absorbed.
C. Wait 2 hours after meals to take the tablet.This is the correct answer because iron is best absorbed on an empty stomach, typically one hour before or two hours after meals. Food can interfere with the absorption of iron, so waiting ensures better efficacy of the supplement.
D. Take the tablet with a daily multivitamin.Taking iron with a multivitamin can be problematic because certain minerals in multivitamins, such as calcium, can inhibit iron absorption. It is better to take iron supplements separately to maximize absorption.
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