A nurse is caring for a client who has chronic renal failure and is receiving epoetin alfa. To check for therapeutic effects, the nurse should monitor which of the following client laboratory tests?
Hemoglobin levels
Iron levels
Platelet count
White blood cell count
The Correct Answer is A
A. Hemoglobin levels. Epoetin alfa stimulates erythropoiesis (red blood cell production) in clients with chronic renal failure, where natural erythropoietin production is impaired. The therapeutic effect of epoetin alfa is measured by monitoring hemoglobin (Hgb) levels to ensure adequate response without exceeding safe limits. Target Hgb levels should not exceed 11 g/dL, as higher levels increase the risk of thromboembolic events and hypertension.
B. Iron levels. While iron is necessary for red blood cell production, epoetin alfa does not directly affect iron levels. However, iron supplementation may be required if iron deficiency is present, as inadequate iron stores can limit the effectiveness of epoetin alfa therapy.
C. Platelet count. Epoetin alfa primarily affects red blood cell production and has no direct effect on platelet levels. Although polycythemia (excess red blood cells) can increase the risk of clot formation, platelet count is not the primary indicator of epoetin alfa’s therapeutic effects.
D. White blood cell count. Epoetin alfa does not impact white blood cell (WBC) production. Leukocyte production is regulated by different growth factors, and WBC monitoring is more relevant for conditions such as infections, chemotherapy-induced neutropenia, or bone marrow disorders.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Deferoxamine. Deferoxamine is a chelating agent used to treat iron overload or toxicity. It has no role in managing an acute allergic reaction or respiratory distress caused by nafcillin, a penicillin-type antibiotic.
B. Vitamin K. Vitamin K is used to reverse the effects of warfarin-induced anticoagulation and is not indicated for treating an allergic reaction. Anaphylaxis is not related to coagulation disturbances, making this an inappropriate intervention.
C. Epinephrine. Epinephrine is the first-line treatment for anaphylaxis, which can present with difficulty breathing, bronchospasm, and hypotension. It works by stimulating alpha- and beta-adrenergic receptors, leading to bronchodilation, increased cardiac output, and vasoconstriction to counteract severe allergic reactions. Immediate administration is necessary to prevent further airway compromise and circulatory collapse.
D. Prednisone. Prednisone is a corticosteroid used to reduce inflammation and prevent delayed allergic reactions. While it may be prescribed as part of long-term management, it does not provide the rapid bronchodilation and vasoconstriction needed for emergency treatment of anaphylaxis.
Correct Answer is D
Explanation
A. Atropine. Atropine is an anticholinergic medication used to treat bradycardia and reduce secretions before surgery. It has no effect on reversing anticoagulation caused by heparin and would not be an appropriate treatment for heparin overdose.
B. Vitamin K. Vitamin K is used as an antidote for warfarin toxicity, as it helps produce clotting factors that warfarin inhibits. However, it does not reverse the effects of heparin, which works by enhancing the activity of antithrombin to prevent clot formation.
C. Vitamin B12. Vitamin B12 is essential for red blood cell production and neurological function, primarily used to treat conditions like pernicious anemia. It does not have any role in reversing the anticoagulant effects of heparin and would not be beneficial in this situation.
D. Protamine. Protamine sulfate is the specific antidote for heparin overdose. It binds to heparin, neutralizing its anticoagulant effects and preventing excessive bleeding. Protamine is administered intravenously in cases of heparin toxicity or when urgent reversal is needed, such as before surgery or in cases of uncontrolled bleeding.
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