A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which of the following laboratory values indicates an adverse effect of this medication?

A. Assess the client for adverse reactions:
After ensuring the client's safety and well-being, the nurse can then proceed with the other necessary actions, such as determining the factors that led to the omission, filing an incident report, and reporting the missed dosage to the client's provider. However, assessing the client for any immediate adverse reactions takes precedence to address any potential harm that may have resulted from the missed medication dose.
B. Determine factors that led to the omission:
This is the correct answer. Understanding the factors that led to the omission is crucial for preventing future errors. The nurse should assess if there were any system failures, distractions, or other factors contributing to the missed dose.However, patient's safety and wellbeing comes first.
C. File an Incident report:
Filing an incident report is an important step, but it should not be the first action. The nurse needs to address the immediate situation and assess the factors contributing to the omission first.
D. Report the missed dosage to the client's provider:
Reporting the missed dosage to the provider is an important step, but it should not be the first action. The nurse needs to address the immediate situation, assess the client, and determine factors leading to the omission before reporting to the provider.

A. "Lie down for 1 hour after administering the medication.": This statement is not necessary for nasal cyanocobalamin administration. There is no need for the client to lie down for an extended period after administering the medication.
B. "Administer the medication into one nostril once per week.": This is the correct information. Nasal cyanocobalamin is typically administered once a week for the treatment of pernicious anemia. It's important for the nurse to emphasize the correct frequency and route of administration to ensure the effectiveness of the treatment.
C. "Plan to self-administer this medication for the next 6 months.": The duration of treatment may vary based on the healthcare provider's prescription. The nurse should instruct the client based on the specific instructions provided by the healthcare provider rather than a predetermined time frame.
D. "Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.": This statement is not a standard recommendation for nasal cyanocobalamin administration. If the client has concerns about a stuffy nose, they should consult with their healthcare provider rather than using a nasal decongestant without guidance.