A nurse is caring for a client who is prescribed cyclosporine.
Which of the following findings should the nurse report to the provider immediately?

The client requests to have grapefruit juice.

Increased serum bilirubin level.

The client reports hair growth on their body.

Blood pressure 128/82 mm Hg.

Answer and Explanation

The Correct Answer is A

Choice A rationale

Grapefruit juice contains compounds that inhibit cytochrome P450 3A4 (CYP3A4) enzymes in the small intestine. Cyclosporine is metabolized by CYP3A4. Concomitant ingestion of grapefruit juice can lead to increased serum cyclosporine levels, raising the risk of toxicity, including nephrotoxicity and neurotoxicity.

Choice B rationale

An increased serum bilirubin level can indicate liver dysfunction, which is a potential adverse effect of cyclosporine. However, without specific values or other symptoms, this finding alone might not be an immediate emergency, though it warrants further investigation to assess liver health. Normal total bilirubin is 0.3 to 1.2 mg/dL.

Choice C rationale

Hair growth (hirsutism) is a common and recognized side effect of cyclosporine therapy, particularly in women. While it can be bothersome cosmetically, it is generally not indicative of an immediate or life-threatening adverse event and does not require urgent reporting.

Choice D rationale

A blood pressure of 128/82 mm Hg is slightly elevated but generally considered within an acceptable range, although on the higher side of normal. Cyclosporine can cause hypertension, but this specific reading does not represent a hypertensive crisis or an immediate emergency requiring urgent intervention.

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Free Nursing Study Resources

Correct Answer is ["3"]

Explanation

Step 1 is: Convert client weight from pounds to kilograms. 165 Ib ÷ 2.2 Ib/kg = 75 kg.

Step 2 is: Calculate the total dose of verapamil needed. 0.1 mg/kg × 75 kg = 7.5 mg.

Step 3 is: Calculate the volume to administer in mL. 7.5 mg ÷ (2.5 mg/mL) = 3 mL. The nurse should administer 3 mL.

A. Magnesium 1.5 mEq/L (1.3 to 2.1 mEq/L). B. Calcium 9.2 mg/dL (9 to 10.5 mg/dL). C. Sodium 140 mEq/L (136 to 145 mEq/L). D. Potassium 4.8 mEq/L (3.5 to 5 mEq/L).

Correct Answer is A

Explanation

Choice A rationale

Magnesium levels within the normal range (1.3 to 2.1 mEq/L) are important for overall electrolyte balance, but sodium polystyrene sulfonate specifically targets potassium. While hyperkalemia can sometimes be associated with other electrolyte imbalances, a normal magnesium level does not directly indicate a therapeutic response to sodium polystyrene sulfonate, as its primary action is not on magnesium.

Choice B rationale

Calcium levels within the normal range (9 to 10.5 mg/dL) are essential for various physiological functions. Sodium polystyrene sulfonate primarily exchanges sodium ions for potassium ions, not calcium. Therefore, a normal calcium level does not reflect a therapeutic response to the medication, which is specifically aimed at reducing elevated potassium levels.

Choice C rationale

Sodium levels within the normal range (136 to 145 mEq/L) are crucial for fluid balance and neurological function. Sodium polystyrene sulfonate exchanges sodium for potassium, meaning it increases the body's sodium load. While a normal sodium level is desirable, it does not directly indicate the therapeutic efficacy of the medication in reducing potassium.

Choice D rationale

Potassium 4.8 mEq/L (3.5 to 5 mEq/L) indicates a therapeutic response. Sodium polystyrene sulfonate is an ion-exchange resin used to treat hyperkalemia by exchanging potassium ions for sodium ions in the gastrointestinal tract. A potassium level returning to within the normal range, from a previously elevated state, signifies that the medication has effectively lowered the excess potassium.

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A nurse is caring for a client who is prescribed cyclosporine. Which of the following findings should the nurse report to the provider immediately?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is preparing to administer verapamil 0.1 mg/kg via intermittent IV bolus over 2 min. Available is verapamil 2.5 mg/mL. The client weighs 165 Ib. How many mL should the nurse administer?

Correct Answer is ["3"]

Explanation

A nurse is reviewing the laboratory report for a client who has been taking sodium polystyrene sulfonate. Which of the following findings indicates a therapeutic response to the medication?

Correct Answer is A

Explanation

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A nurse is caring for a client who is prescribed cyclosporine.
Which of the following findings should the nurse report to the provider immediately?