Practice Question
A nurse is reviewing the laboratory findings of a client who is taking erythropoietin. Which of the following results indicates the medication is effective?
Answer Choices:
Correct Answer:
Increased hemoglobin
Rationale:
🩸 Erythropoietin (EPO) stimulates the bone marrow to produce more red blood cells, thereby increasing hemoglobin (Hgb) and hematocrit (Hct).
🩸 It is commonly used in clients with anemia of chronic kidney disease or other conditions causing low RBC production.
🩸 When the medication is effective, the nurse should see a rise in hemoglobin toward the target range over several weeks.
🩸 This translates into improved oxygen-carrying capacity, less fatigue, and better tolerance of activity.
🩸 Therefore, an increased hemoglobin level is the best indicator that erythropoietin therapy is working.
Decreased white blood cells
🩸 Erythropoietin primarily affects the erythrocyte (RBC) line, not white blood cell (WBC) production.
🩸 A decrease in WBC count could actually be concerning, suggesting bone marrow suppression, infection, or other pathology, not beneficial effect.
🩸 The goal of EPO treatment is correction of anemia, not modification of immune cell counts.
🩸 Monitoring WBC is important for other reasons, but it does not measure the specific therapeutic effect of erythropoietin.
🩸 Thus, a decreased WBC count does not indicate effectiveness of this drug.
Increased calcium
🩸 Calcium levels are mostly related to parathyroid function, bone metabolism, renal excretion, and vitamin D status, not directly to erythropoietin action.
🩸 Erythropoietin does not have a primary effect on serum calcium.
🩸 A change in calcium could signal other metabolic issues but does not measure RBC production.
🩸 Therefore, increased calcium is not a relevant indicator of EPO therapy success.
🩸 The nurse should instead focus on hemoglobin and hematocrit values.
Decreased BUN
🩸 Blood urea nitrogen (BUN) reflects kidney function, hydration status, and protein metabolism, not erythropoietin’s direct action on RBC production.
🩸 While many clients on EPO have chronic kidney disease, improvement in anemia may not immediately change BUN levels.
🩸 EPO helps correct anemia of kidney disease, not the underlying renal impairment.
🩸 A decreased BUN might be due to improved hydration or diet, but it is not the target marker for EPO therapy.
🩸 Thus, decreased BUN does not demonstrate the effectiveness of erythropoietin.
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This question is from RN PHARMACOLOGY 2023 ✅ which contains 65 questions.
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Question Details
- Category: RN Nursing Exam(s)
- Subcategory: ATI Exam(s)
- Domain: RN ATI Pharmacology
- Answer Choices: 4