A 55-yr-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication?
Blood pressure 98/56 mm Hg
Creatinine 1.6 mg/dL
Oxygen saturation 89%
Hemoglobin level 13 g/dL
The Correct Answer is D
A. Blood pressure 98/56 mm Hg: A slightly low blood pressure is not a contraindication to epoetin alfa administration. The major concern with this medication is hypertension, not hypotension, so this finding would not prevent giving the dose.
B. Creatinine 1.6 mg/dL: Elevated creatinine is expected in end-stage kidney disease and does not affect the decision to administer epoetin alfa. This medication is used specifically to manage anemia related to chronic kidney disease.
C. Oxygen saturation 89%: A low oxygen saturation reflects hypoxemia, but epoetin alfa does not treat oxygenation problems directly. Supplemental oxygen and pulmonary assessment would be the priority, but this finding is not a contraindication to giving the drug.
D. Hemoglobin level 13 g/dL: Epoetin alfa stimulates red blood cell production, and giving it when hemoglobin is already elevated increases the risk of serious adverse effects such as thrombosis, stroke, and hypertension. Reporting this value is essential drug administration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. RBC: Chronic glomerulonephritis often leads to anemia because the damaged kidneys produce less erythropoietin, a hormone necessary for red blood cell production. A decrease in RBC count is therefore an expected finding in this condition.
B. Potassium: Potassium levels usually increase rather than decrease in chronic glomerulonephritis because of reduced kidney function and impaired excretion. Hyperkalemia is a common complication that requires close monitoring.
C. Phosphate: Phosphate levels tend to rise in chronic kidney disease since the kidneys cannot excrete phosphate efficiently. This leads to hyperphosphatemia, which contributes to bone mineral imbalances, not a decrease.
D. Creatinine: Creatinine levels increase in chronic glomerulonephritis because of impaired filtration and reduced clearance. Elevated serum creatinine is one of the key indicators of declining kidney function.
Correct Answer is C
Explanation
A. Providing perineal hygiene to patients daily and as needed: Good perineal care helps reduce bacterial colonization in the genital area, but it does not prevent bacteria from entering the bladder when a catheter is present. While important, it is not the primary measure.
B. Encouraging adequate oral fluid and nutritional intake: Adequate hydration supports urinary flow, dilutes urine, and may help flush bacteria, but it does not directly address the most common cause of HAIs, which is catheter-associated urinary tract infection (CAUTI).
C. Avoiding unnecessary urinary catheterization: The majority of urinary tract HAIs are linked to indwelling catheters. Minimizing their use, limiting duration, and using alternatives whenever possible are the most effective strategies to reduce infection risk in hospitalized patients.
D. Testing urine with a dipstick daily for nitrites: Routine daily dipstick testing does not prevent infection but only detects its presence after it has developed. It is not recommended as a preventive measure and would not reduce the rate of HAIs.
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