A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse.

Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (Select all that apply)

Metformin is a medication used to lower blood glucose levels in people with type 2 diabetes. Metoprolol is a beta-blocker used to treat high blood pressure and heart problems. If the nurse accidentally gives metformin instead of metoprolol, the client may experience hypoglycemia (low blood sugar), which can cause symptoms such as sweating, shakiness, confusion, and loss of consciousness. Therefore, the nurse should check the client’s glucose level and treat hypoglycemia if needed.

Choice A is wrong because HDL (high-density lipoprotein) is a type of cholesterol that is not affected by metformin or metoprolol.

Choice B is wrong because thyroid function levels are not affected by metformin or metoprolol.

Choice C is wrong because uric acid level is not affected by metformin or metoprolol.

Uric acid is a waste product that can cause gout if it accumulates in the joints. Normal ranges for blood glucose are 70 to 130 mg/dL before meals and less than 180 mg/dL two hours after meals.

Normal ranges for HDL are 40 to 60 mg/dL for men and 50 to 60 mg/dL for women.

Normal ranges for thyroid function levels vary depending on the specific test, but generally they are between 0.4 and 4.0 mIU/L for TSH (thyroid-stimulating hormone), 4.5 to 11.2 mcg/dL for T4 (thyroxine), and 80 to 180 ng/dL for T3 (triiodothyronine).

Normal ranges for uric acid are 3.4 to 7.0 mg/dL for men and 2.4 to 6.0 mg/dL for women.

Colesevelam is a bile acid sequestrant that lowers cholesterol by binding to bile acids in the intestine and preventing their reabsorption into the bloodstream. Some possible explanations for the other choices are:

Choice A. Chlorpromazine is wrong because it is an antipsychotic medication that has no effect on cholesterol levels.

Choice C. Colchicine is wrong because it is an anti-inflammatory drug that is used to treat gout and other inflammatory conditions, not high cholesterol.

Choice D. Cimetidine is wrong because it is a histamine H2 receptor antagonist that reduces stomach acid production and is used to treat ulcers and gastroesophageal reflux disease (GERD), not high cholesterol.

Normal ranges for cholesterol levels vary depending on the type of cholesterol and the risk factors of the individual, but generally, total cholesterol should be less than 200 mg/dL, LDL cholesterol should be less than 100 mg/dL, HDL cholesterol should be more than 40 mg/dL for men and 50 mg/dL for women, and triglycerides should be less than 150 mg/dL.