A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should the nurse report to the provider?
Hct 44%
WBC count 5,000/mm3
Potassium 4.2 mEq/L
Total bilirubin 1.5 mg/dL
The Correct Answer is D
Choice A Reason:
Hct 44% is incorrect. A hematocrit (Hct) level of 44% falls within the normal range for most adults. It represents the proportion of red blood cells in the blood and is not typically concerning unless it significantly deviates from the normal range, indicating anemia or polycythemia.
Choice B Reason:
WBC count 5,000/mm3 is incorrect. A white blood cell (WBC) count of 5,000/mm3 falls within the normal range for adults, reflecting a normal immune response. There's usually no cause for immediate concern unless there are specific clinical symptoms or significant deviations from the normal range.
Choice C Reason:
Potassium 4.2 mEq/L is incorrect. A potassium level of 4.2 mEq/L is within the normal range for serum potassium levels. It's crucial to monitor potassium levels, especially with medications that can affect electrolyte balance, but this value falls within the typical range and may not prompt immediate action unless there are notable fluctuations or clinical symptoms related to potassium imbalance.
While the majority of the laboratory values provided fall within the normal range, the value that the nurse should consider reporting to the provider, particularly when a client is taking amitriptyline, is:
Choice D Reason:
Total bilirubin 1.5 mg/dL is correct. Elevated levels of total bilirubin might indicate potential liver function impairment. Amitriptyline, an antidepressant, can affect liver enzymes in some individuals, causing hepatic changes. Therefore, it's crucial to monitor liver function tests, including total bilirubin, during amitriptyline therapy. An increase in bilirubin levels could signal hepatotoxicity or liver dysfunction related to the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A Reason:
Levothyroxine 100 mcg PO every morning is incorrect. Indicates the dosage (100 mcg) and the route (by mouth) to be taken every morning.
Choice B Reason:
Simvastatin 40 mg PO at bedtime: Specifies the dosage (40 mg) and the timing (at bedtime) for administration.
Choice C Reason:
Acetaminophen 500 mg every 4 hr RN for fever is correct. The term "RN" in this context might be interpreted as "right now" rather than the intended meaning, which could cause confusion regarding the frequency of acetaminophen administration. The nurse should seek clarification to ensure accurate and safe dosing instructions.
Choice D Reason:
Morphine 4 mg IV every 4 hr PRN for pain: Specifies the dosage (4 mg), the route (intravenous), and the frequency (every 4 hours as needed) for pain management.
Correct Answer is C
Explanation
Choice A Reason:
Determine factors that led to the omission. Understanding why the dosage was missed is crucial. Was there a specific reason such as an interruption, conflicting priorities, or confusion in the medication schedule? Identifying these factors can help prevent future omissions and improve the medication administration process.
Choice B Reason:
File an incident report. If the missed dosage poses any potential risk or deviation from the prescribed treatment plan, it's important to document the incident through an incident report. This ensures transparency and allows the healthcare team to address and learn from the situation.
Choice C Reason:
Report the missed dosage to the client's provider. Informing the client's healthcare provider about the missed dosage is crucial. The provider can assess the situation and provide guidance on whether any adjustments or additional steps are necessary to ensure the client's well-being.
Choice D Reason:
Assess the client for adverse reactions. Monitoring the client for any adverse reactions or changes in their condition is essential after a missed dosage. This observation helps detect any potential effects of the missed medication and allows for prompt intervention if needed.
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