An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication?
An increase in serum lactate
A decrease in hemoglobin and hematocrit
An increase in white blood cells
A decrease in potassium accompanied by an increase in sodium
The Correct Answer is A
A. An increase in serum lactate – This is a critical laboratory value that can indicate lactic acidosis, a serious side effect associated with metformin, especially in older adults or those with renal impairment. An increase in serum lactate necessitates discontinuation of the medication.
B. A decrease in hemoglobin and hematocrit – While this change may indicate anemia, it is not directly associated with the need to discontinue metformin. Further evaluation of the cause of anemia would be necessary.
C. An increase in white blood cells – This could indicate an infection or inflammatory process but does not specifically necessitate the discontinuation of metformin.
D. A decrease in potassium accompanied by an increase in sodium – While electrolyte imbalances should be monitored, this change does not directly indicate that metformin should be discontinued.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Disulfiram is a medication used to treat alcohol use disorder (AUD). It works by inhibiting the enzyme acetaldehyde dehydrogenase, which is responsible for breaking down acetaldehyde, a toxic metabolite of alcohol. When alcohol is consumed while taking disulfiram, the accumulation of acetaldehyde in the body leads to unpleasant symptoms such as flushing, sweating, nausea, and vomiting. This creates an aversive reaction to alcohol consumption, which can help the client refrain from drinking.
The aversive effects of disulfiram can last for several hours to several days after alcohol consumption, depending on the dose of disulfiram and the amount of alcohol consumed. Therefore, it is important for clients taking disulfiram to avoid all sources of alcohol, including alcoholic beverages, mouthwash, and other products containing alcohol.
It is important to note that disulfiram is not a cure for AUD, and it works best when used as part of a comprehensive treatment plan that includes counseling and support. Disulfiram should only be used under the close supervision of a healthcare provider, as it can have serious side effects if used improperly.
Correct Answer is C
Explanation
Dextroamphetamine is a central nervous system (CNS) stimulant that is used to treat ADHD and narcolepsy. The drug has a high potential for abuse and dependence, and therefore it carries a black box warning from the FDA. The black box warning is the strongest warning that the FDA requires, and it indicates that a drug has a significant risk of serious or life-threatening adverse effects.
The black box warning for dextroamphetamine relates to its potential for abuse, addiction, and misuse. The drug should only be used as directed by a healthcare provider, and clients should be advised not to share their medication with others or to take more than the prescribed dose. Excessive doses of dextroamphetamine can lead to serious adverse effects, including stroke and heart attack. Clients should also be advised to store their medication securely and to dispose of any unused medication properly.
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