When the nurse is assessing a client with chronic kidney disease who is receiving epoetin alfa injections. Which finding will the nurse report to the healthcare provider?

A. Hemoglobin level is 8.9 g/dL: This value is within the target range for clients receiving epoetin alfa, which is generally used to maintain hemoglobin between 10–11 g/dL. Although it is slightly low, it is not a critical finding that warrants immediate provider notification. B. Blood pressure is 198/92 mm Hg: Severe hypertension is a known adverse effect of epoetin alfa and a contraindication for continued use. Elevated blood pressure can increase the risk of cardiovascular events, so this finding must be promptly reported. C. The client is afraid of subcutaneous injections: Fear of injections is an emotional concern and can be managed through education and reassurance. While it may affect compliance, it is not clinically urgent and does not require immediate provider involvement. D. The client has a history of myocardial infarction: A prior MI is relevant but it is not an immediate contraindication for epoetin alfa unless the client is currently unstable or symptomatic. This history should be considered during long-term planning but is not an urgent finding.