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 C
Explanation
The drug will eradicate my tumor and cure my cancer" establishes the need for further clarification. While mitotane is used to treat adrenocortical carcinoma, it is not considered a curative treatment. The other statements made by the client demonstrate a correct understanding of the medication and its administration.
Correct Answer is D
Explanation
would rule out a diagnosis of adrenal insufficiency after a short plasma corticotropin (ACTH) stimulation test. In this test, a synthetic form of ACTH is given to stimulate the adrenal glands to produce cortisol. If the adrenal glands are functioning normally, they should produce an increased amount of cortisol in response to the ACTH. Therefore, if the client has elevated cortisol levels after the test, it would indicate that their adrenal glands are functioning properly and ruling out adrenal insufficiency.
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