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A client is to receive his first dose of epoetin (Epogen). Which of the following client assessment findings would be a contraindication to the nurse administering the medication?

1. A hemoglobin level of 10 grams/dL
2. A blood glucose level of 280 mg/dL
3. A blood pressure of 180/100
4. A heart rate of 58 beats per minute

Explanation

Uncontrolled hypertension is a contraindication for the administration of epoetin because the increase in hematocrit increases blood viscosity and peripheral vascular resistance. This will lead to a further increase in blood pressure. A hemoglobin level lower than 10 mg/dL would not be a contraindication, as the use of epoetin is associated with an increase in the hemoglobin and hematocrit levels. While an elevated blood glucose level is significant, it is not a contraindication for the use of epoetin. Similarly, a heart rate of 58 beats per minute would not impact the client’s ability to tolerate epoetin therapy. To accurately answer the question, the learner must understand the indication for using epoetin. Based upon this knowledge, select responses can be eliminated. An understanding of the physiological response of the medication also is necessary, as is evident in this scenario.

Contributor

Andrew
Member since: April 2011
(Boynton Beach,FL) Original question source

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