A 55-yr-old patient with end-stage kidney disease (ESKD) is scheduled to receive a prescribed dose of epoetin alfa (Procrit). Which information should the nurse report to the health care provider before giving the medication?

A. Blood pressure 98/56 mm Hg: A slightly low blood pressure is not a contraindication to epoetin alfa administration. The major concern with this medication is hypertension, not hypotension, so this finding would not prevent giving the dose. B. Creatinine 1.6 mg/dL: Elevated creatinine is expected in end-stage kidney disease and does not affect the decision to administer epoetin alfa. This medication is used specifically to manage anemia related to chronic kidney disease. C. Oxygen saturation 89%: A low oxygen saturation reflects hypoxemia, but epoetin alfa does not treat oxygenation problems directly. Supplemental oxygen and pulmonary assessment would be the priority, but this finding is not a contraindication to giving the drug. D. Hemoglobin level 13 g/dL: Epoetin alfa stimulates red blood cell production, and giving it when hemoglobin is already elevated increases the risk of serious adverse effects such as thrombosis, stroke, and hypertension. Reporting this value is essential drug administration.