A nurse is reviewing the medical record of a client who is taking epoetin alfa. Which of the following laboratory tests should the nurse monitor to determine the effectiveness of the medication? (Select all that apply.)

The nurse should monitor the following laboratory tests to determine the effectiveness of epoetin alfa:

B. Hemoglobin: Epoetin alfa is a medication used to treat anemia by stimulating red blood cell production. Monitoring hemoglobin levels can help assess if the medication is effectively increasing red blood cell production and improving anemia.

E. Iron: Iron is essential for red blood cell production. Monitoring iron levels can help determine if the client has adequate iron stores to support the increased production of red blood cells stimulated by epoetin alfa.

The other options listed, A. Thyroid-stimulating hormone, C. Blood glucose, and D. Alanine aminotransferase, are not directly related to the effectiveness of epoetin alfa in treating anemia. Thyroid-stimulating hormone is related to thyroid function, blood glucose is related to blood sugar control, and alanine aminotransferase is related to liver function. While these tests may be important for monitoring the overall health of the client, they are not specific indicators of the effectiveness of epoetin alfa.

A. Intake and output: Monitoring intake and output is essential in the postoperative care of a client to assess fluid balance and kidney function. However, it is not the priority assessment when the client has received isoflurane in the PACU. The priority assessment in this situation is related to the potential cardiovascular side effect of isoflurane, which is hypotension. Hypotension can have immediate and significant implications for the client's perfusion and overall well-being, requiring prompt attention and intervention.

B. Non-verbal pain cues: Assessing for pain is important in the postoperative period to ensure adequate pain management and comfort for the client. However, it is not the priority assessment when the client has received isoflurane in the PACU. The priority assessment at this time is related to the potential cardiovascular impact of the anesthesia, which is blood pressure. Addressing hypotension takes precedence over pain assessment as it poses a more immediate threat to the client's well-being.

C. Bowel sounds: Assessing bowel sounds is part of a comprehensive postoperative assessment to monitor the return of bowel function after surgery. While it is important, it is not the priority assessment when the client has received isoflurane in the PACU. The priority assessment in this situation is related to the potential cardiovascular side effect of the anesthesia, which is blood pressure. Monitoring and managing hypotension is of greater concern in the immediate postoperative period.

D. Blood pressure: This is the correct answer. The priority assessment for a client who received isoflurane in the PACU is the blood pressure. Isoflurane is an inhalation anesthetic that can cause hypotension (low blood pressure). Monitoring the client's blood pressure is crucial to promptly identify and address any hypotension, as it can lead to inadequate tissue perfusion and oxygenation. Addressing blood pressure deviations is essential for the client's cardiovascular stability and overall recovery in the PACU.