A nurse is reviewing laboratory values for a client who is receiving long-term NSAID therapy for rheumatoid arthritis. Which of the following values should the nurse report to the provider?

Epoetin alfa is a medication used to stimulate erythropoiesis, the production of red blood cells. An increase in the client's hemoglobin level indicates that the medication has been effective. The normal range of hemoglobin for adult females is 12-16 g/dL and for adult males is 13.5-17.5 g/dL. A hemoglobin level of 11 g/dL is slightly below the normal range, but it is an improvement from a lower level. Choice B, WBC count 9,000/mm3 is unrelated to the medication and is within the normal range. Choice

C, total calcium 10 mg/dL, and choice D, PT 12 seconds, are also unrelated to the medication and are within the normal range.

Choice B (WBC count 9,000/mm3) is not an answer because it is unrelated to the medication and is within the normal range.

Choice C (total calcium 10 mg/dL) is not an answer because it is unrelated to the medication and is within the normal range.

Choice D (PT 12 seconds) is not an answer because it is unrelated to the medication and is within the normal range.

The correct answer is choice B: Store opened insulin vials at room temperature for up to 4 weeks.

Choice B rationale: Opened insulin vials can be stored at room temperature (59°F to 86°F or 15°C to 30°C) for up to 4 weeks. After this period, the insulin may lose potency, and a new vial should be used.

Choice A rationale: Regular insulin is short-acting, and its peak effect occurs 2 to 3 hours after administration. Eating a snack 6 hours after insulin administration may not be necessary as the insulin would have already reached its peak effect, and blood glucose levels should be monitored accordingly.

Choice C rationale: Warming the insulin vial to dissolve crystals is not recommended. Insulin should be inspected before use, and if crystals or clumps are present, it should be discarded as this could indicate that the insulin has lost its effectiveness.

Choice D rationale: Unopened insulin vials should be stored in the refrigerator (36°F to 46°F or 2°C to 8°C) and should not be frozen. Freezing can cause insulin to lose potency or become ineffective. Once opened, insulin vials can be stored at room temperature for up to 4 weeks, as mentioned in choice B.