A nurse is interviewing a preoperative patient scheduled for a total hip replacement. Which of the following failings would require the nurse to collaborate with the surgeon immediately before sending the patient to the operating room?

Choice A reason: A clear liquid diet the day before a colonoscopy ensures the bowel is free of solid residue, allowing clear visualization of the colon mucosa. Clear liquids like broth, juice, or water do not leave particulate matter, facilitating effective bowel cleansing with laxatives, critical for accurate detection of polyps or abnormalities during the procedure.

Choice B reason: Taking antibiotics the morning of a colonoscopy is not standard practice. Antibiotics are not routinely required for bowel preparation, as the procedure carries a low infection risk. They may be used in specific cases, like patients with heart valve conditions, but this is not a general instruction for colonoscopy preparation.

Choice C reason: Drinking milk is contraindicated during colonoscopy preparation. Milk is not a clear liquid and leaves residue in the bowel, obstructing visualization during the procedure. A clear liquid diet is required to ensure the colon is clean, as dairy products can interfere with effective bowel cleansing and diagnostic accuracy.

Choice D reason: Avoiding water during bowel prep is incorrect. Adequate hydration is essential during colonoscopy preparation to prevent dehydration from laxative-induced fluid loss. Drinking water supports bowel cleansing and maintains electrolyte balance, ensuring patient safety and comfort during the prep process and the procedure itself.

Choice A reason: Zidovudine, a nucleoside reverse transcriptase inhibitor, commonly causes bone marrow suppression, leading to anemia, neutropenia, or thrombocytopenia. It inhibits DNA synthesis in rapidly dividing bone marrow cells, reducing red blood cell, white blood cell, and platelet production. Monitoring complete blood counts is essential to detect these hematologic toxicities early and manage them appropriately.

Choice B reason: Metabolic alkalosis is not a known adverse effect of zidovudine. The drug primarily affects hematopoiesis and mitochondrial function, not acid-base balance. Metabolic alkalosis may occur in conditions like excessive vomiting or diuretic use, but zidovudine’s mechanism does not alter bicarbonate or pH levels, making this an unlikely complication.

Choice C reason: Hypoglycemia is not associated with zidovudine. The drug’s primary toxicities involve bone marrow and mitochondrial dysfunction, not glucose metabolism. Hypoglycemia may occur with other conditions or medications, like insulin, but zidovudine does not affect pancreatic function or glucose regulation, so monitoring for this is unnecessary in this context.

Choice D reason: Hyperkalemia is not a recognized side effect of zidovudine. The drug’s adverse effects center on hematologic and muscular systems, not electrolyte balance. Hyperkalemia may result from renal dysfunction or other medications, but zidovudine does not disrupt potassium homeostasis, so it is not a priority for monitoring in this patient.