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?
BUN 15 mg/dL
WBC 3,000/mm²
Het 45W
Platelets 250.000/mm²
The Correct Answer is B
A. BUN 15 mg/dL (Blood Urea Nitrogen):
BUN is a measure of kidney function, and an elevated BUN may suggest impaired kidney function. However, it is not a specific marker for azathioprine adverse effects.
B. WBC 3,000/mm² (White Blood Cell count):
This is the correct answer. Azathioprine can suppress bone marrow function, leading to leukopenia (low white blood cell count). A WBC count of 3,000/mm² indicates a lower-than-normal white blood cell count, which can increase the risk of infection.
C. Hct 45% (Hematocrit):
Hematocrit measures the percentage of red blood cells in the blood. While it can be affected by various factors, it is not a specific marker for azathioprine adverse effects.
D. Platelets 250,000/mm²:
Platelets are involved in blood clotting, and a platelet count of 250,000/mm² is within the normal range. Azathioprine is not typically associated with adverse effects on platelet counts.
Nursing Test Bank
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Related Questions
Correct Answer is C
Explanation
A.PT (Prothrombin Time) 11 seconds: The prothrombin time measures the extrinsic pathway of the coagulation cascade. A PT of 11 seconds is within the normal range, and it indicates that the extrinsic clotting pathway is functioning appropriately. There is no need to report this value.
B. APTT (Activated Partial Thromboplastin Time) 50 seconds: The APTT measures the intrinsic pathway of the coagulation cascade. A value of 50 seconds is prolonged and may suggest that the client is receiving an effective anticoagulant dose. However, the APTT target range can vary based on the specific therapeutic goal and the heparin protocol in use. It's essential to follow the healthcare provider's guidance on the target APTT range.
C. Hematocrit 456: The normal range for hematocrit is usually expressed as a percentage. A value of 456 is outside the normal range and likely represents an error or a misinterpretation. The nurse should verify this value, as an extremely high hematocrit could be indicative of an issue such as dehydration or an analytical error.
D. Platelets 300,000/mm²: A platelet count of 300,000/mm² is within the normal range. There is no need to report this value as it suggests a normal platelet count.
Correct Answer is B
Explanation
A. Potassium 4.2 mEq/L: While potassium levels should be monitored during amitriptyline therapy, the value of 4.2 mEq/L is within the normal range. There is no immediate concern based on this potassium level.
B. Total bilirubin 1.5 mg/dL
Amitriptyline, a tricyclic antidepressant, can sometimes cause hepatotoxicity, which may manifest as elevated liver enzymes or bilirubin levels. Therefore, any abnormality in liver function tests, such as total bilirubin, should be reported to the provider for further evaluation and management.
C. WBC count 5,000/mm³: The white blood cell count is not a commonly monitored parameter for amitriptyline, and the value of 5,000/mm³ is within the normal range. There is no immediate concern based on this WBC count.
D. Hct 44:The hematocrit (Hct) level is related to the percentage of red blood cells in the blood.A value of44%falls within the normal range for hematocrit. There’s no immediate concern related to amitriptyline use based on this result either.
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