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 erythrocyte sedimentation rate (ESR)
The hematocrit (Hct)
The leukocyte count
The platelet count
The Correct Answer is B
A. The erythrocyte sedimentation rate (ESR) is a nonspecific marker of inflammation and is not used to assess the therapeutic effect of epoetin alfa.
B. The hematocrit (Hct) measures the proportion of red blood cells in the blood. Epoetin alfa stimulates the production of red blood cells, leading to an increase in hematocrit levels, indicating a therapeutic effect of the medication.
C. The leukocyte count measures the number of white blood cells in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.
D. The platelet count measures the number of platelets in the blood and is not relevant for assessing the therapeutic effect of epoetin alfa.
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Related Questions
Correct Answer is D
Explanation
A. Respiratory acidosis would typically involve an elevated PaCO2, which is not seen in this case.
B. Metabolic alkalosis is characterized by an elevated bicarbonate level, which is not present in this scenario.
C. Respiratory alkalosis would present with a low PaCO2 and an elevated pH, which is not the case here.
D. The low bicarbonate level (HCO3) 18mEq/L (normal range of 22-26 mEq/L), and low pH 7.30 (normal range of 7.35-7.45), indicate metabolic acidosis. suggesting acidemia. The PaCO2 is also low at 28 mm Hg, indicating a respiratory compensation for the metabolic acidosis.
Correct Answer is C
Explanation
A. The pH is alkalotic, and the PaCO2 is within the normal range, indicating respiratory alkalosis, which is not typically seen in chronic kidney disease.
B. The pH is alkalotic, and the HCO3 level is lower than normal, indicating metabolic acidosis, which can occur in chronic kidney disease, but the PaCO2 is not typically decreased in metabolic acidosis.
C. This choice fits the pattern of metabolic acidosis commonly seen in CKD patients. In patients with chronic kidney disease (CKD), the kidneys are less able to excrete acid, leading to metabolic acidosis. Therefore, the expected arterial blood gas values would show a lower pH indicating acidemia, a decreased bicarbonate (HCO3-) level, and a normal or low partial pressure of carbon dioxide (PaCO2) as the lungs try to compensate by blowing off CO2.
D. The pH is acidic, and the HCO3 level is within the normal range, indicating respiratory acidosis, which is not typically seen in chronic kidney disease.
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