A male client is admitted for observation because he is reporting progressively increasing fatigue over the past month and a brief episode of dizziness that occurred today. He has a history of heartburn and indigestion that he self-treats with ibuprofen and antacids. Which assessment finding should the nurse report immediately to the healthcare provider?

Reference Ranges:
Hemoglobin (14 to 18 g/dL (8.7 to 11.2 mmol/L)]
Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]
Gastric pH [1.5 to 3.5]

Hematocrit 42% (0.42 volume fraction).

Hemoglobin 13 g/dL (8.07 mmol/L).

Positive guaiac of stool.

Gastric pH 2.0.

Answer and Explanation

The Correct Answer is C

A. Hematocrit 42% (0.42 volume fraction):
A hematocrit of 42% is within the normal reference range for males (42% to 52%). While it is important to monitor hematocrit levels, this finding alone does not indicate an immediate issue.

B. Hemoglobin 13 g/dL (8.07 mmol/L):
A hemoglobin level of 13 g/dL is slightly below the normal range for males (14 to 18 g/dL). However, it is not critically low and may not require immediate intervention without additional context or symptoms.

C. Positive guaiac of stool:
A positive guaiac test for stool indicates the presence of occult blood in the stool, which could suggest gastrointestinal bleeding. Given the client's history of heartburn, indigestion, and use of ibuprofen (a nonsteroidal anti-inflammatory drug that can cause gastrointestinal bleeding), this finding is concerning and should be reported immediately to the healthcare provider for further evaluation and management.

D. Gastric pH 2.0:
A gastric pH of 2.0 is within the normal range for gastric acid, as the normal pH of gastric acid typically ranges from 1.5 to 3.5. This finding is expected and does not indicate an immediate problem related to the client's symptoms.

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Correct Answer is C

Explanation

A. Do not take the medication more than once every 8 hours:
Diphenhydramine is typically dosed every 4 to 6 hours, not just once every 8 hours. However, this instruction is less critical compared to addressing the safety concerns related to drowsiness.

B. Take the medication with food to prevent gastric upset:
Diphenhydramine is generally not known to cause significant gastric upset, so this instruction is less critical. The primary concern with diphenhydramine is its sedative effects rather than gastrointestinal issues.

C. Avoid driving, since this medication causes drowsiness:
Diphenhydramine is known to cause significant drowsiness and sedation. Advising the client to avoid driving is crucial to prevent accidents and ensure their safety, making this the most important instruction.

D. Use sugarless candy or gum to help prevent a dry mouth:
While diphenhydramine can cause dry mouth, using sugarless candy or gum is a helpful but secondary instruction. The primary concern with diphenhydramine is its sedative effect, which affects the client's ability to drive safely.

A. High density lipoprotein (HDL) B. Low density lipoprotein (LDL). C. Creatine phosphokinase (CK). D. Prothrombin time (PT).

Correct Answer is B

Explanation

A. High density lipoprotein (HDL):
HDL levels are important for cardiovascular health as higher levels are associated with a lower risk of coronary artery disease. However, atorvastatin primarily targets LDL levels. While increasing HDL is beneficial, it is not the primary measure of atorvastatin's effectiveness.

B. Low density lipoprotein (LDL):
Atorvastatin is a statin medication used to lower LDL cholesterol levels, which is a major risk factor for coronary artery disease. A decrease in LDL levels indicates that the medication is having its desired effect, reducing the risk of cardiovascular events.

C. Creatine phosphokinase (CK):
CK levels are monitored to assess muscle damage or side effects related to statin use, such as rhabdomyolysis. While important for safety monitoring, changes in CK levels do not directly reflect the effectiveness of atorvastatin in managing cholesterol levels.

D. Prothrombin time (PT):
PT is used to evaluate blood clotting ability and is not directly related to the effectiveness of atorvastatin. It is more relevant for monitoring anticoagulant therapy rather than statin therapy for cholesterol management.

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Correct Answer is C

Explanation

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Correct Answer is B

Explanation

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