A nurse is caring for a client diagnosed with polycythemia.
Which clinical manifestations can the nurse expect to assess in this client? .

Choice A rationale:

Administer ruxolitinib to reduce spleen size.

Rationale: This option is not a priority in the care plan for a client with secondary polycythemia.

Secondary polycythemia is typically associated with an underlying condition, such as chronic hypoxia.

The primary focus should be on addressing the underlying cause and managing polycythemia-related complications.

Choice B rationale:

Monitor electrolyte levels and renal function.

Rationale: This is the correct priority in the care plan for a client with secondary polycythemia.

Secondary polycythemia can result from conditions like chronic obstructive pulmonary disease (COPD) or renal disease, which may affect electrolyte balance and renal function.

Monitoring these parameters is essential to assess the patient's overall health and manage the underlying condition.

Choice C rationale:

Administer radioactive phosphorus.

Rationale: Administering radioactive phosphorus is not a standard treatment for secondary polycythemia.

Treatment for secondary polycythemia focuses on managing the underlying condition and its complications.

Choice D rationale:

Perform phlebotomy to reduce hematocrit.

Rationale: Phlebotomy may be considered in some cases of secondary polycythemia, but it is not the primary priority.

The primary focus should be on addressing the underlying cause, such as treating COPD or renal disease, to manage polycythemia effectively.

Choice A rationale:

Feeling tired and weak is a common symptom of polycythemia due to the increased viscosity of the blood.

However, this is a general symptom and not specific to polycythemia alone.

Many conditions can cause fatigue.

Choice B rationale:

Red and flushed skin is a characteristic sign of polycythemia.

Increased red blood cell count can lead to increased blood flow to the skin, resulting in a flushed appearance.

This is a specific symptom of polycythemia and should be assessed during the physical examination.

Choice C rationale:

Frequent nosebleeds can occur in polycythemia due to increased blood viscosity and pressure on blood vessels.

This is another specific symptom that should be assessed in a patient with suspected polycythemia.

Choice D rationale:

Shortness of breath can also be a symptom of polycythemia, especially when there is an excessive increase in red blood cells.

However, like fatigue, it is not specific to polycythemia and can be caused by various respiratory and cardiac conditions.