The client who has been taking glipizide for 6 months reports to the nurse that his urine has become darker since starting the medication. What is the nurse's first action?
Test a sample of urine for the presence of occult blood
Check the client's weight
Instruct the client to increase his water intake
Review results of liver function studies
The Correct Answer is D
A. While testing for occult blood can help rule out hematuria (blood in the urine), it’s not the immediate priority. Dark urine could be related to several factors, including dehydration or changes in liver function, making this not the best first step.
B. While monitoring weight is important, it doesn't directly address the issue of dark urine. Weight changes might indicate fluid retention or loss but are not as immediately relevant to the urine color change.
C. Increasing water intake can help dilute the urine and may help with hydration. However, before suggesting this, it's important to understand the underlying cause of the urine change.
D. Glipizide and other sulfonylureas can affect liver function, and dark urine can indicate potential liver issues, such as bilirubinuria (bilirubin in the urine). Reviewing liver function studies would provide critical information to assess if the change in urine color is related to liver dysfunction or other serious issues.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["C","D","E"]
Explanation
A. Clients on warfarin should generally avoid nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and ibuprofen, as these can increase the risk of bleeding. Instead, acetaminophen is often recommended for pain relief, but it should be used cautiously and under a healthcare provider’s guidance.
B. While vitamin K found in green, leafy vegetables can affect warfarin levels, clients do not need to eliminate these foods entirely. Instead, they should maintain a consistent intake of vitamin K-rich foods to help manage their INR levels. Sudden changes in diet can lead to fluctuations in anticoagulation control.
C. It is important for clients taking warfarin to wear a medical alert bracelet. This alerts healthcare providers in case of an emergency, as the client may require special care due to their anticoagulant therapy.
D. Using an electric razor is a safer option for clients on warfarin as it reduces the risk of cuts and bleeding compared to using a traditional razor. This is an important safety measure for those on anticoagulation therapy.
E. Monitoring prothrombin time (PT) and International Normalized Ratio (INR) is essential for clients on warfarin to ensure they are within the therapeutic range. Regular testing helps to manage the dosage effectively and minimize the risk of bleeding or thrombosis.
Correct Answer is A
Explanation
A. Clients with PAD often experience claudication (pain in the legs due to inadequate blood flow) during exercise. They should be encouraged to walk to the point of pain, then rest until the pain subsides, and then continue walking. This approach can improve circulation over time.
B. While it’s crucial to monitor leg ulcers, exercise can still be beneficial unless advised otherwise by a healthcare provider. Walking can promote circulation, which is important for healing. However, if a leg ulcer is present, the client should consult their healthcare provider about appropriate activity levels.
C. While elevating the feet can help reduce swelling, it's generally more beneficial for clients with PAD to keep their legs in a dependent position after walking. This position encourages blood flow to the legs, which can help alleviate symptoms and improve circulation.
D. Exercise that encourages movement and maintains blood flow to the legs is important for those with PAD. While certain positions may exacerbate symptoms, exercises like walking should be encouraged. Keeping the feet in a dependent position can help with blood flow post-exercise.
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