A client with chronic renal disease is experiencing manifestations of anemia. Based on this data, which treatment should the nurse anticipate for this client?

Administration of erythropoietin (Epoetin).

Transfusion of red blood cells (RBCs).

Weekly monitoring of complete blood count (CBC).

An order for iron replacement medication.

Answer and Explanation

The Correct Answer is A

A. Administration of erythropoietin (Epoetin): In chronic renal disease, the kidneys may not produce enough erythropoietin, leading to anemia. Epoetin is a synthetic form of erythropoietin that stimulates red blood cell production and is commonly used to treat anemia in these clients.

B. Transfusion of red blood cells (RBCs): While transfusion of RBCs may be necessary in severe cases of anemia or acute blood loss, it is not the first-line treatment for anemia related to chronic renal disease. Erythropoietin-stimulating agents are preferred to stimulate endogenous RBC production.

C. Weekly monitoring of complete blood count (CBC): Monitoring of CBC is important to assess the response to treatment and adjust therapy as needed but does not represent a specific treatment for anemia in chronic renal disease.

D. An order for iron replacement medication: Iron replacement may be indicated if iron deficiency is contributing to the anemia, but it is not the primary treatment for anemia in chronic renal disease. Erythropoietin-stimulating agents are typically used first to address the underlying cause of anemia.

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Correct Answer is B

Explanation

A. Heart rate of 90 bpm: While an elevated heart rate may be expected in response to burn injury and the body's stress response, a heart rate of 90 bpm alone may not be concerning without additional context.

B. Blood pressure of 96/50 mm Hg: This blood pressure reading indicates hypotension, which can be a sign of inadequate tissue perfusion, fluid loss, or shock. It requires prompt notification of the healthcare provider for further assessment and intervention.

C. Urine output of 2 mL/kg per hour: Adequate urine output is important for renal function and fluid balance, and a urine output of 2 mL/kg per hour is within the normal range. While changes in urine output should be monitored, this finding alone does not require immediate notification of the healthcare provider.

D. Pain rating of 7 on a 1 to 10 point scale: Pain management is important in burn care, but a pain rating of 7 on a 1 to 10 scale is not unusual in clients with burns and may not require immediate notification of the healthcare provider unless accompanied by other concerning symptoms.

A. Dyspnea B. Malaise C. Fever D. Anorexia

Correct Answer is A

Explanation

A. Dyspnea: Worsening dyspnea may indicate complications such as heart failure or embolization of infectious material to the lungs, which can occur in infective endocarditis as a result of vegetation formation on heart valves. Dyspnea can suggest decreased cardiac output or pulmonary involvement, indicating a worsening condition.

B. Malaise: Malaise is a nonspecific symptom that is common in infective endocarditis due to systemic infection and inflammation. While it can be present in both mild and severe cases, it may not specifically indicate worsening of the condition without other signs of deterioration.

C. Fever: Fever is a hallmark symptom of infective endocarditis and may persist or worsen with progressive infection. However, fever alone may not necessarily indicate worsening if the client is already febrile due to the underlying infection.

D. Anorexia: Anorexia or loss of appetite can occur in infective endocarditis due to systemic illness but may not specifically indicate worsening without other signs of deterioration. It is important to assess for other signs of worsening condition, such as hemodynamic instability or embolic events, in conjunction with anorexia.

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A client with chronic renal disease is experiencing manifestations of anemia. Based on this data, which treatment should the nurse anticipate for this client?

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