Question

A 32-year-old woman has systemic lupus erythematosus and chronic kidney disease. Over the past 2 weeks, she has complained of feeling fatigued and short of breath after minimal exertion. She is receiving hemodialysis. Her hemoglobin level is 4.5 g/dl. Which of the following is indicated?

1) Recombinant human erythropoietin (Epogen)
2) Two units of packed red blood cells
3) Nitroglycerin sublingual as needed
4) Azathioprine

Answer 1

The patient's symptoms and low hemoglobin level indicate a treatment with recombinant human erythropoietin (Epogen) is needed to stimulate erythropoiesis and help alleviate anemia caused by chronic kidney disease.

Step-by-step explanation:

A 32-year-old woman with systemic lupus erythematosus and chronic kidney disease is experiencing fatigue and shortness of breath after minimal exertion and has a very low hemoglobin level of 4.5 g/dl. With chronic kidney disease, her kidneys are likely not producing sufficient erythropoietin (EPO), which is essential for the production of red blood cells (erythrocytes).

One of the primary treatments for anemia caused by renal failure is the administration of recombinant human erythropoietin to stimulate erythropoiesis. Given the patient's symptoms and low hemoglobin level, the most indicated treatment would be recombinant human erythropoietin (Epogen), which would help alleviate the symptoms of anemia and improve oxygen delivery to tissues.