A client with polycythemia is undergoing additional tests to rule out secondary causes.
Which diagnostic test is commonly used to rule out secondary polycythemia?

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:

Headache.

Rationale: Headaches are a common symptom of polycythemia due to the increased blood volume and viscosity, which can lead to impaired blood flow and oxygen delivery to the brain.

Choice B rationale:

Fatigue.

Rationale: Fatigue is also a common symptom of polycythemia due to the increased workload on the heart and decreased oxygen-carrying capacity of the blood.

Choice C rationale:

Epistaxis.

Rationale: Epistaxis, or nosebleeds, can occur in individuals with polycythemia because of the increased pressure on blood vessels and the fragility of the nasal mucosa caused by elevated red blood cell counts.

Choice D rationale:

Increased blood pressure.

Rationale: Elevated blood pressure can result from polycythemia due to the increased volume of blood in circulation, which can strain the cardiovascular system.

Choice E rationale:

Gout.

Rationale: Gout is a potential complication of polycythemia because the increased production of red blood cells can lead to elevated levels of uric acid, a risk factor for gout.