Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

Serum calcium

Serum creatinine

Hemoglobin and Hematocrit

White blood cell count (WBC)

Answer and Explanation

The Correct Answer is B

Serum creatinine is the most important laboratory value to review before administering an antibiotic that can cause nephrotoxicity. Nephrotoxicity is an alteration in the function of the kidney due to exposure to certain drugs or toxins.

It can be assessed by measuring the glomerular filtration rate (GFR), which is the rate of clearance of a substance from the blood by the kidneys. Serum creatinine is a waste product of muscle metabolism that is freely filtered by the glomeruli and not reabsorbed or secreted by the tubules.

Therefore, it is a reliable indicator of GFR and renal function. An increase in serum creatinine indicates a decrease in GFR and renal function, which may be caused by nephrotoxic drugs.

The other laboratory values are not directly related to nephrotoxicity or GFR:

Serum calcium: This may be aﬀected by renal function, but it is not a sensitive or specific marker of nephrotoxicity. It may be altered by other factors such as vitamin D, parathyroid hormone, and bone metabolism.
Hemoglobin and hematocrit: These may be aﬀected by renal function, but they are not sensitive or specific markers of nephrotoxicity. They may reﬂect the erythropoietin production by the kidneys, which stimulates red blood cell production in the bone marrow. However, they may also be inﬂuenced by other factors such as blood loss, hydration status, and iron deficiency.
White blood cell count (WBC): This is not related to nephrotoxicity or GFR. It may reﬂect the presence of infection or inﬂammation, which may be a cause or a consequence of renal impairment, but it is not a direct measure of renal function.

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Correct Answer is D

Explanation

Choice A rationale:

Systemic autoimmune vasculopathy is not a typical underlying disease pathology associated with a waddling gait and frequent falls in a 5-year-old child. This choice is not relevant to the symptoms described.

Choice B rationale:

Autonomic neuropathy may manifest with a variety of symptoms, including autonomic dysregulation, but it is not a common underlying pathology leading to a waddling gait and frequent falls in a child. This choice is not relevant to the symptoms described.

Choice C rationale:

Impaired neuron function can result in various neurological symptoms, but it does not specifically explain the waddling gait and frequent falls in a 5-year-old child. This choice is not relevant to the symptoms described.

Choice D rationale:

A. Offer supplemental formula feedings. B. Teach about the use of a breast pump. C. Recommend using a breast shield. D. Encourage the use of ice on the areola.

Correct Answer is C

Explanation

The correct answer is c. Recommend using a breast shield.

Choice A reason: Offering supplemental formula feedings is not the first-line action for inverted nipples as it does not address the issue and may lead to nipple confusion, potentially complicating future breastfeeding attempts.

Choice B reason: Teaching about the use of a breast pump is beneficial for milk expression but does not directly assist with the immediate concern of latching issues due to inverted nipples.

Choice C reason: Using a breast shield can be helpful for mothers with inverted nipples. It can temporarily draw out the nipple, allowing the baby to latch on more easily. This tool acts as a bridge between the breast and the baby's mouth, facilitating breastfeeding while the mother works on long-term solutions for her inverted nipples.

Choice D reason: Encouraging the use of ice on the areola may temporarily stiffen the nipple, but it is not a recommended practice for addressing inverted nipples as it can cause discomfort and may not be effective in promoting a successful latch.

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Before administering an antibiotic that can cause nephrotoxicity, which laboratory value is most important for the practical nurse (PN) to review?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A 5-year-old child with a history of a waddling gait and frequent falls is brought into the hospital for diagnostic testing.When explaining the diagnostic testing to the parents, the nurse should provide information based on which understanding of the underlying disease pathology?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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