The nurse is caring for a client who has chronic renal disease and is receiving therapy with erythropoietin (epoetin alpha). Which of the following laboratory results should the nurse review as an indication of a therapeutic effect of this medication?

A. Magnesium sulfate: Magnesium sulfate is used for eclampsia and torsades de pointes, not for reducing shivering.

B. Kayexalate: This medication is used for hyperkalemia, not temperature control.

C. Acetaminophen: While useful for fever, acetaminophen does not stop shivering.

D. Diazepam: Shivering increases metabolic demand and body temperature. Diazepam (a benzodiazepine) is a muscle relaxant that helps control shivering in hyperthermic clients.

A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.

B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.

C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.

D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.