Administer ruxolitinib to reduce spleen size. Rationale: This option is not a priority in the care plan for a client with secondary polycythemia. Secondary polycythemia is typically associated with an underlying condition, such as chronic hypoxia. The primary focus should be on addressing the underlying cause and managing polycythemia-related complications.

Monitor electrolyte levels and renal function. Rationale: This is the correct priority in the care plan for a client with secondary polycythemia. Secondary polycythemia can result from conditions like chronic obstructive pulmonary disease (COPD) or renal disease, which may affect electrolyte balance and renal function. Monitoring these parameters is essential to assess the patient's overall health and manage the underlying condition.

Administer radioactive phosphorus. Rationale: Administering radioactive phosphorus is not a standard treatment for secondary polycythemia. Treatment for secondary polycythemia focuses on managing the underlying condition and its complications.

Perform phlebotomy to reduce hematocrit. Rationale: Phlebotomy may be considered in some cases of secondary polycythemia, but it is not the primary priority. The primary focus should be on addressing the underlying cause, such as treating COPD or renal disease, to manage polycythemia effectively. Leukemia Objectives Introduction Etiology of Leukemia Pathophysiology of Leukemia