A nurse is caring for a client who has chronic renal disease and is receiving therapy with epoetin alfa. Which of the following laboratory results should the nurse review for an indication of a therapeutic effect of the medication?
A.
The erythrocyte sedimentation rate (ESR)
B.
The hematocrit (Hct)
C.
The leukocyte count
D.
The platelet count
The Correct answer and Explanation is:
The correct answer is B. The hematocrit (Hct).
Explanation:
Epoetin alfa is a synthetic form of erythropoietin, a hormone produced by the kidneys that stimulates the production of red blood cells (RBCs). This medication is often used in patients with chronic renal disease because the kidneys, which are compromised in such conditions, are unable to produce sufficient erythropoietin on their own. By providing epoetin alfa, the aim is to increase the production of RBCs and subsequently improve hemoglobin levels and overall red blood cell counts.
Laboratory Tests Related to Epoetin Alfa Therapy:
- Hematocrit (Hct): The hematocrit test measures the proportion of blood volume occupied by red blood cells. As epoetin alfa stimulates erythropoiesis (the production of red blood cells), an increase in hematocrit indicates that the therapy is having the desired effect. In chronic renal disease, the hematocrit often decreases due to anemia, so a rising hematocrit level suggests that epoetin alfa is effectively increasing the number of red blood cells in circulation.
- Erythrocyte Sedimentation Rate (ESR): This test measures the rate at which red blood cells settle at the bottom of a test tube over a specific period. While it can provide information about inflammation or disease activity, it is not directly related to the effectiveness of epoetin alfa therapy.
- Leukocyte Count: This measures the number of white blood cells in the blood. Epoetin alfa does not have a direct impact on white blood cell counts, so this lab result is not useful for assessing the therapeutic effect of epoetin alfa.
- Platelet Count: This measures the number of platelets in the blood, which are involved in clotting. Although chronic renal disease and anemia can sometimes affect platelet counts, epoetin alfa’s primary effect is on red blood cells, not platelets.
In summary, for monitoring the therapeutic effects of epoetin alfa in a patient with chronic renal disease, the hematocrit is the key laboratory value to assess. An increase in hematocrit indicates that the medication is effectively stimulating red blood cell production, which is the intended outcome of the therapy.