After a diagnosis of chronic kidney disease (CKD), the client was started on epoetin. Which finding indicates that the medication has been effective?
Increase in serum hematocrit.
Increase in serum calcium.
Decrease in serum creatinine levels.
Decrease in blood pressure.
The Correct Answer is A
Choice A reason: An increase in serum hematocrit indicates that epoetin has been effective. Epoetin, also known as erythropoietin, is a medication used to stimulate the production of red blood cells. In patients with chronic kidney disease, the kidneys may not produce enough natural erythropoietin, leading to anemia. By administering epoetin, the goal is to increase red blood cell production, which is reflected in higher hematocrit levels (the proportion of red blood cells in the blood).
Choice B reason: An increase in serum calcium is not related to the effectiveness of epoetin. Serum calcium levels are regulated by different mechanisms, including parathyroid hormone and vitamin D, and are not directly influenced by epoetin administration.
Choice C reason: A decrease in serum creatinine levels would indicate improved kidney function, but this is not the expected outcome of epoetin therapy. Epoetin specifically targets red blood cell production and does not have a direct impact on kidney function or creatinine levels.
Choice D reason: A decrease in blood pressure is also not an expected indicator of epoetin effectiveness. While managing blood pressure is important in chronic kidney disease, epoetin's primary role is to address anemia by stimulating red blood cell production. Blood pressure regulation involves other medications and interventions.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E","F"]
Explanation
Choice A reason: Increased serum calcium is not typically associated with advanced liver disease. Hypercalcemia (increased serum calcium) may be seen in conditions like hyperparathyroidism, certain cancers, or excessive vitamin D intake, but it is not a common finding in liver disease.
Choice B reason: Decreased serum ammonia is also not associated with advanced liver disease. In fact, patients with liver disease often have increased serum ammonia levels due to the liver's inability to effectively detoxify ammonia into urea. Elevated ammonia can lead to hepatic encephalopathy, a serious complication of liver disease.
Choice C reason: Increased ALT and AST are common laboratory findings in advanced liver disease. These liver enzymes, alanine aminotransferase (ALT) and aspartate aminotransferase (AST), are released into the bloodstream when liver cells are damaged or inflamed. Elevated levels indicate liver injury or dysfunction and are often used to assess the extent of liver disease.
Choice D reason: Decreased albumin is a typical finding in advanced liver disease. Albumin is a protein produced by the liver, and its levels drop when the liver is no longer able to synthesize it effectively. Low albumin levels can lead to edema and ascites due to decreased oncotic pressure in the blood vessels.
Choice E reason: Elevated bilirubin is expected in advanced liver disease. Bilirubin is a byproduct of red blood cell breakdown that is normally processed and excreted by the liver. When liver function is impaired, bilirubin accumulates in the blood, leading to jaundice, characterized by yellowing of the skin and eyes.
Choice F reason: Elevated prothrombin time (PT) is a common finding in advanced liver disease. The liver produces clotting factors necessary for blood coagulation, and when it is damaged, these factors are not produced adequately, leading to prolonged PT. This indicates a higher risk of bleeding and impaired clotting function.
Correct Answer is A
Explanation
Choice A reason: Warfarin is an anticoagulant commonly used in patients with atrial fibrillation to prevent the formation of blood clots. Atrial fibrillation increases the risk of stroke due to the potential for blood clots forming in the heart and traveling to the brain. Warfarin helps reduce this risk by thinning the blood and preventing clot formation.
Choice B reason: Atropine is used to treat bradycardia (slow heart rate) and is not typically used for patients with atrial fibrillation. Its primary function is to increase the heart rate by blocking the vagus nerve's effects on the heart. In the context of atrial fibrillation, anticoagulation is more crucial to prevent complications like stroke.
Choice C reason: Dobutamine is an inotropic agent used to increase cardiac output in patients with heart failure or cardiogenic shock. It is not used for managing atrial fibrillation. Dobutamine works by stimulating the heart to pump more effectively but does not address the risks associated with atrial fibrillation, such as blood clot formation.
Choice D reason: Magnesium sulfate is used to treat various conditions, including torsades de pointes (a type of abnormal heart rhythm) and severe asthma attacks. It is not typically used for atrial fibrillation. The focus in atrial fibrillation management is on controlling the heart rate or rhythm and preventing thromboembolic complications with anticoagulation therapy.
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