The nurse is caring for a client who has chronic renal disease and is receiving therapy with erythropoietin (epoetin alpha). Which of the following laboratory results should the nurse review as an indication of a therapeutic effect of this medication?

A. The development of malignant hyperthermia: Malignant hyperthermia (MH) is a life-threatening reaction to certain anesthetics (e.g., succinylcholine, halothane). It causes rapid muscle breakdown, severe hyperthermia, tachycardia, muscle rigidity, and metabolic acidosis. Immediate treatment with IV dantrolene and cooling measures is required.

B. The development of fluid volume excess: Fluid overload may cause hypertension and pulmonary edema but does not cause sudden high fever.

C. The development of an allergic response to the pain medication: Drug allergies typically present with rash, itching, or anaphylaxis, not extreme fever.

D. The development of an infection. Post-op infections usually develop over several days, not immediately in PACU.

A. Obtain vital signs: Dizziness and lightheadedness during dialysis suggest hypotension, a common complication. The nurse should first assess vital signs to determine the severity before taking further action.

B. Bolus the client with 1000 mL of normal saline: If the client is hypotensive, a smaller fluid bolus (e.g., 250–500 mL) would be more appropriate.

C. Turn off the dialysis machine immediately: Stopping dialysis abruptly may cause fluid overload and other complications. The rate may need adjustment but not immediate cessation.

D. Notify the health care provider as soon as possible: While important, assessing the client’s current status is the priority before contacting the provider.