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:
Oxygen saturation within this range is generally considered adequate and might not directly correlate with the administration of albumin.
Choice B Reason:
Decrease in protein is incorrect. Albumin infusions are meant to supplement protein levels in the blood, so a decrease in protein wouldn't be an expected finding.
Choice C Reason:
Increase in blood pressure is correct. Albumin infusions can potentially help increase blood volume, leading to an increase in blood pressure. In shock, where there's a significant decrease in blood pressure due to reduced circulating volume, administering albumin or other intravenous fluids can help restore blood volume and consequently raise blood pressure towards a more stable range.
Choice D Reason:
PaCO2 of 30 mm Hg is incorrect. PaCO2 levels are related to respiratory function and the amount of carbon dioxide in the blood. While shock can impact various physiological parameters, a PaCO2 level of 30 mm Hg alone might not be directly tied to the administration of albumin in shock.
Correct Answer is C
Explanation
Choice A Reason:
Withdrawing the NPH insulin from the vial should come after injecting air into the NPH vial.
Choice B Reason:
Injecting air into the regular insulin vial should occur after withdrawing the NPH insulin from its vial.
Choice C Reason:
Inject air into the NPH vial is correct. The sequence for mixing regular insulin (clear) and NPH insulin (cloudy) in the same syringe typically involves injecting air into the NPH (cloudy) insulin vial first. This step prevents excess pressure buildup when withdrawing the solution, making it easier to draw the correct amount of NPH insulin into the syringe.
Choice D Reason:
Withdrawing the regular insulin from the vial should occur after withdrawing the correct amount of NPH insulin into the syringe.
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