A nurse is reviewing a client's laboratory results before administering furosemide 40 mg IV bolus. For which of the following values should the nurse withhold the medication and contact the provider?

Choice A Reason:
Oral is incorrect. Epoetin alfa is not typically administered orally because it would be broken down by digestive enzymes and not absorbed effectively from the gastrointestinal tract.
Choice B Reason:
Intravenous is correct. Epoetin alfa is a medication used to stimulate red blood cell production and is commonly administered intravenously. This route allows for rapid and efficient absorption of the medication into the bloodstream, enabling it to exert its effects effectively.
Choice C Reason:
Inhalation is incorrect. Inhalation is not a route used for epoetin alfa. This medication is intended for systemic effects rather than local effects in the respiratory system.
Choice D Reason:
Transdermal is incorrect. Transdermal administration involves absorption through the skin and is not suitable for epoetin alfa, which needs rapid and direct access to the bloodstream for its action on red blood cell production.

Choice A Reason:
Decreased respiratory rate is incorrect. Heparin administration and an elevated aPTT typically do not directly cause a decrease in respiratory rate. Respiratory rate changes might occur due to other factors such as respiratory conditions, pain, or medications affecting the respiratory center, but they are not commonly linked to heparin therapy.
Choice B Reason:
Increased blood pressure is incorrect. Heparin therapy and an elevated aPTT do not typically result in increased blood pressure. Heparin's primary effect is on preventing blood clotting, and while it can indirectly affect blood pressure by preventing clot formation, it doesn't typically cause a significant increase in blood pressure.
Choice C Reason:
Decreased temperature is incorrect. Heparin therapy and an elevated aPTT do not generally cause a decrease in body temperature. Changes in body temperature might occur due to various reasons such as infection, environmental factors, or certain medications, but they are not directly linked to heparin administration.
Choice D Reason:
Increased pulse rate is correct. An increased pulse rate can be an early indicator of bleeding or a potential side effect of heparin administration. Heparin's anticoagulant effect might predispose individuals to bleeding, so an increased pulse rate could indicate a response to potential bleeding complications rather than a direct effect of heparin itself.