The nurse is performing a morning assessment on a patient admitted for serious burns to the extremities. For what reason does the nurse assess the patient's abdomen?

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.

Choice A reason: Administering a vasopressor is not appropriate for low afterload. Vasopressors are used to increase blood pressure by causing vasoconstriction, which increases afterload. However, the administration of a vasopressor for low afterload is contradictory because the goal for low afterload would be to reduce the strain on the heart, not to increase it.

Choice B reason: Administering a vasodilator for low afterload is not correct. Vasodilators decrease afterload by causing the blood vessels to widen, reducing the resistance the heart has to pump against. Administering a vasodilator to treat low afterload is inappropriate because it would further lower afterload, potentially leading to inadequate perfusion and worsening cardiac output.

Choice C reason: Administering diuretics for low right atrial (RA) pressure is inappropriate. Diuretics help to remove excess fluid from the body, reducing blood volume and venous pressure. However, if a patient has low right atrial pressure, reducing blood volume further with diuretics could exacerbate the issue, leading to decreased cardiac output and poor perfusion.

Choice D reason: Administering a fluid bolus is the correct intervention for low preload. Preload refers to the volume of blood in the ventricles at the end of diastole. If preload is low, administering fluids increases blood volume, which enhances ventricular filling and improves cardiac output. This intervention helps to stabilize hemodynamics and improve overall perfusion.

Choice E reason: Administering a diuretic or vasodilator is the appropriate intervention for high preload. High preload indicates an excess of blood volume returning to the heart, which can strain the cardiac muscle and reduce efficiency. Diuretics help remove excess fluid, while vasodilators decrease venous return and reduce the volume of blood the heart has to handle, thus optimizing cardiac function and output.