An older client with chronic renal failure and weekly dialysis has anemia. Which intervention is most important for the nurse to implement for this client?

Question

1. Frequent blood pressure assessment
2. Erythropoietin injection
3. Administer ferrous sulfate orally
4. Monitor for hematuria

Answer 1

2. Erythropoietin injection

Explanation: 1. Anemia associated with renal failure does not cause clinically significant changes in the client's blood pressure, when managed correctly, because the body compensates for the chronically low level.
2. Anemia associated with renal failure is related to the loss of erythropoietin, which is produced by the healthy kidney and stimulates bone marrow to produce red blood cells. Erythropoietin is replaced via injection on a regular basis for those with renal insufficiency.
3. Iron replacement can be useful in anemia, but iron does not correct the cause for the client with renal failure. In chronic renal failure, iron stores are normal.
4. Renal failure causes the loss of protein, not blood, through the urine. If the client produces urine, it may be darkly colored, making it difficult to determine the presence of blood, and urinalysis is not indicated unless the client exhibits overt manifestations of hematuria.