After a diagnosis of chronic kidney disease (CKD), the client was started on epoetin. Which finding indicates that the medication has been effective?

Choice A reason: Administering 2 tablets of digoxin 0.125 mg would provide the correct dosage of 0.25 mg. However, given the client's heart rate of 54/min, administering the medication could further lower the heart rate, which can be dangerous. The nurse should withhold the medication and notify the physician.

Choice B reason: Withholding the digoxin dose for decreased heart rate is the correct action. Digoxin is used to slow down the heart rate and strengthen heart contractions. A heart rate of 54/min is considered bradycardia (slow heart rate), and administering digoxin could exacerbate the bradycardia, leading to potential complications such as heart block or severe arrhythmias. Therefore, it is critical to withhold the medication and inform the physician of the client's current heart rate.

Choice C reason: Administering one tablet of digoxin 0.125 mg would not provide the full prescribed dose of 0.25 mg. More importantly, the client's low heart rate makes it unsafe to administer any dose of digoxin at this time.

Choice D reason: Withholding the digoxin dose for elevated blood pressure is not appropriate. Although the client has elevated blood pressure (144/96), the more immediate concern is the low heart rate. Digoxin affects heart rate more than blood pressure, and the risk of exacerbating bradycardia takes precedence.

Choice A reason: Completion of antibiotic therapy does not necessarily correlate with a decrease in the risk of infection in burn patients. While antibiotics can help manage existing infections, the risk for new infections remains until the burn wounds are fully healed. Open burn wounds provide a portal of entry for pathogens, and the presence of necrotic tissue can further increase infection risk.

Choice B reason: Returning albumin levels to normal can improve the overall nutritional status and healing process of a burn patient, but it does not directly reduce the risk of infection. Albumin levels are more indicative of the patient's nutritional status and fluid balance. The primary concern for infection risk remains the open burn wounds, which serve as a direct route for pathogens.

Choice C reason: Completion of the fluid resuscitation process is crucial for stabilizing a burn patient's hemodynamic status and ensuring adequate perfusion to tissues. However, fluid resuscitation does not directly impact the risk of infection. The risk of infection is predominantly related to the presence and extent of open burn wounds.

Choice D reason: The correct response is that the risk for infection significantly decreases when all of the burn wounds have closed. Closed wounds provide a barrier against pathogens and reduce the risk of infection. Wound closure can be achieved through natural healing or surgical interventions such as skin grafting. Until the wounds are fully closed, the patient remains at a high risk for infection.