A client whose hemoglobin level was 6 gm/dL 2 days ago has received parenteral epoetin alfa. A hemoglobin level has just been drawn to evaluate therapy. The nurse would consider which hemoglobin lab result as most problematic?
1. 13–14 gm/dL
2. 7–8 gm/dL
3. 11–12 gm/dL
4. 9–10 gm/dL
Correct Answer: 1
Rationale 1: If the level exceeds 12 gm/dL, the risk of blood clots increases, which puts the client at risk for stroke and heart attack.
Rationale 2: Epoetin alfa therapy is given to increase the hemoglobin and hematocrit. This reading is increasing, which is a positive outcome.
Rationale 3: A hemoglobin level of 11–12 gm/dL is approaching serious levels but is still normal.
Rationale 4: A hemoglobin level of 9–10 gm/dL is a good level for this client.
Global Rationale: If the level exceeds 12 gm/dL, the risk of blood clots increases, which puts the client at risk for stroke and heart attack. Epoetin alfa therapy is given to increase the hemoglobin and hematocrit. This reading is increasing, which is a positive outcome. A hemoglobin level of 11–12 gm/dL is approaching serious levels but is still normal. A hemoglobin level of 9–10 gm/dL is a good level for this client.
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