A nurse is caring for a client who has a new prescription for metformin. Which of the following laboratory results should the nurse evaluate prior to administering the first dose?
Potassium level
Creatinine level
Platelet count
Liver enzymes
The Correct Answer is B
Before administering the first dose of metformin, the nurse should evaluate the client's creatinine level. Metformin is primarily excreted by the kidneys, and its clearance from the body depends on the renal function. If the client has impaired kidney function, metformin can accumulate in the body and lead to potential adverse effects, particularly lactic acidosis.
Monitoring the creatinine level helps assess the client's kidney function and determines whether it is safe to administer metformin. If the creatinine level is elevated, indicating reduced kidney function, the nurse should consult with the healthcare provider to determine the appropriate dose adjustment or consider an alternative treatment option.
Let's go through the other options and explain why they are not the priority laboratory results to evaluate before administering metformin:
A. Potassium level: While monitoring potassium levels is important in some situations, it is not a primary concern before administering metformin. Metformin does not have a significant effect on potassium levels, and it is not a medication known for causing hypokalemia (low potassium levels).
C. Platelet count: Metformin does not have a direct impact on platelet count, and evaluating platelet count is not typically required before starting metformin therapy. Platelet count monitoring may be relevant for certain other medications or medical conditions, but it is not specific to metformin administration.
D. Liver enzymes: While it is essential to monitor liver function in clients on long-term metformin therapy, evaluating liver enzymes before the first dose of metformin is not the priority. Metformin is primarily cleared by the kidneys, and liver enzymes are not directly affected by its initial administration. However, ongoing monitoring of liver function may be necessary during long-term
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
The nurse should include lightheadedness as an adverse effect in the teaching for a client who has a new prescription for atenolol. Atenolol is a beta-blocker medication used to treat various conditions, including hypertension and certain heart conditions. One of the common side effects of beta-blockers is orthostatic hypotension, which can cause lightheadedness or dizziness when the client stands up from a sitting or lying position.
Let's go through the other options:
B. Tachycardia: Tachycardia is not an adverse effect of atenolol. In fact, atenolol is used to treat tachycardia by slowing down the heart rate.
C. Dry mouth: Dry mouth is not a typical adverse effect of atenolol. Dry mouth is more commonly associated with anticholinergic medications rather than beta-blockers like atenolol.
D. Bronchodilation: Bronchodilation is not an adverse effect of atenolol. In contrast, atenolol can cause bronchoconstriction (narrowing of the airways) in some individuals, particularly those with asthma or chronic obstructive pulmonary disease (COPD).
Correct Answer is D
Explanation
The nurse should report a creatinine level of 2 mg/dl to the provider as a potential adverse effect of captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat congestive heart failure and hypertension. One of the side effects of ACE inhibitors, including captopril, is the potential to cause kidney problems, leading to an increase in serum creatinine levels.
An increase in serum creatinine may indicate impaired kidney function, and it is essential to monitor kidney function regularly in clients taking ACE inhibitors. Elevated creatinine levels can suggest reduced glomerular filtration rate (GFR) and impaired kidney function, which may require adjustments in medication dosage or further evaluation and management.
Let's go through the other options:
A. Absolute neutrophil count (ANC) 4.000/ mm^3: An absolute neutrophil count of 4.000/ mm^3 is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.
B. Brain natriuretic peptide (BNP) 90 ng/L: A brain natriuretic peptide (BNP) level of 90 ng/L is used to assess heart failure severity. While BNP levels can be helpful in managing congestive heart failure, a BNP level of 90 ng/L is not an adverse effect of captopril that requires immediate reporting.
C. Sodium 140 mEq/l: A sodium level of 140 mEq/L is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.
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