A nurse is reviewing the medication list of a client who has a new prescription for clopidogrel after undergoing coronary artery stenting. Which of the following findings should the nurse report to the provider?

The nurse should report a creatinine level of 2 mg/dl to the provider as a potential adverse effect of captopril. Captopril is an angiotensin-converting enzyme (ACE) inhibitor commonly used to treat congestive heart failure and hypertension. One of the side effects of ACE inhibitors, including captopril, is the potential to cause kidney problems, leading to an increase in serum creatinine levels.

An increase in serum creatinine may indicate impaired kidney function, and it is essential to monitor kidney function regularly in clients taking ACE inhibitors. Elevated creatinine levels can suggest reduced glomerular filtration rate (GFR) and impaired kidney function, which may require adjustments in medication dosage or further evaluation and management.

Let's go through the other options:

A. Absolute neutrophil count (ANC) 4.000/ mm^3: An absolute neutrophil count of 4.000/ mm^3 is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.

B. Brain natriuretic peptide (BNP) 90 ng/L: A brain natriuretic peptide (BNP) level of 90 ng/L is used to assess heart failure severity. While BNP levels can be helpful in managing congestive heart failure, a BNP level of 90 ng/L is not an adverse effect of captopril that requires immediate reporting.

C. Sodium 140 mEq/l: A sodium level of 140 mEq/L is within the normal range, so it is not an adverse effect of captopril that requires immediate reporting.

The nurse should report to the provider that the client is taking ginkgo biloba. Ginkgo biloba is an herbal supplement that can interact with clopidogrel and other antiplatelet medications. It may increase the risk of bleeding when taken concurrently with clopidogrel, which is an antiplatelet medication used to prevent blood clots after coronary artery stenting.

Let's go through the other options:

A. The client is taking acetaminophen: Acetaminophen is not known to have significant interactions with clopidogrel. It is a commonly used pain reliever and fever reducer and does not usually affect the antiplatelet activity of clopidogrel.

B. The client is taking valerian: Valerian is an herbal supplement often used as a sleep aid or to reduce anxiety. While there is limited evidence of significant interactions with clopidogrel, it is generally recommended to use caution when combining valerian with antiplatelet medications. However, it is not as concerning as ginkgo biloba in terms of potential bleeding risk.

C. The client is taking vitamin B6: Vitamin B6 is a water-soluble vitamin and is not expected to have significant interactions with clopidogrel. It is generally considered safe to use vitamin B6 with antiplatelet medications like clopidogrel.