The nurse administers an oral antiviral to a client with shingles. Which finding is most important for the nurse to report to the healthcare provide?

Elevated liver function tests.

Vomiting and diarrhea.

Decreased white blood cell count.

Pruritus and muscle aches.

Answer and Explanation

The Correct Answer is A

Rationale:
A. Elevated liver function tests: Oral antivirals such as acyclovir or valacyclovir are metabolized by the liver, and elevated liver enzymes may indicate hepatotoxicity. This finding is critical and may necessitate discontinuation or dose adjustment to prevent liver damage.

B. Vomiting and diarrhea: These are common side effects of oral antivirals and are usually self-limiting. They typically do not require discontinuation unless they lead to dehydration or are severe and persistent.

C. Decreased white blood cell count: A decreased white blood cell can be a side effect of some antiviral medications, and while it increases the risk of infection, it is usually monitored during long-term therapy. However, in the context of acute shingles treatment with an oral antiviral, elevated liver function tests often represent a more immediate concern.

D. Pruritus and muscle aches: These symptoms may occur with antiviral use but are usually mild and nonspecific. They should be monitored but are not as immediately concerning as signs of liver dysfunction.

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Correct Answer is A

Explanation

Rationale:

A. Prevent injury: In CKD, high phosphate and low calcium levels contribute to bone demineralization, increasing fracture risk. Hypocalcemia can also cause muscle cramps and tetany, making fall prevention and safety a priority.

B. Prevent infection: While infection is a general concern in CKD, these specific lab findings do not indicate immunosuppression. The primary issue here relates to bone health and calcium-phosphate imbalance, not immune function.

C. Protect skin integrity: Skin care is important in CKD, especially with pruritus, but it is not the direct consequence of calcium-phosphate imbalance. The immediate risk related to these values is musculoskeletal, not dermatologic.

D. Manage fluid volume: Fluid volume control is essential in CKD but unrelated to phosphate-calcium shifts. These labs reflect mineral and bone metabolism disturbances, not volume overload or deficit.

A. Red edematous stomal appearance. B. Stomal output of 40 mL in last hour. C. Liquid brown drainage from stoma. D. Mucous strings floating in the drainage.

Correct Answer is C

Explanation

Rationale:
A. Red edematous stomal appearance: A bright red, moist, and mildly edematous stoma is expected in the immediate postoperative period. These features indicate healthy perfusion and normal healing after surgery.

B. Stomal output of 40 mL in last hour: This is a normal output volume for a ureteroileostomy. Urine flows continuously in small amounts, and 30–60 mL per hour is considered within normal limits for adequate renal function.

C. Liquid brown drainage from stoma: Brown liquid drainage suggests fecal contamination or leakage from the bowel, which is abnormal in a urinary diversion and may indicate a serious complication such as bowel injury or fistula formation. This requires urgent evaluation.

D. Mucous strings floating in the drainage: Mucus production from the ileal segment is expected because intestinal mucosa continues to secrete mucus even after being repurposed as a urinary conduit. This finding is not concerning.

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The nurse administers an oral antiviral to a client with shingles. Which finding is most important for the nurse to report to the healthcare provide?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

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Correct Answer is C

Explanation

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