The nurse is administering SUBO enoxaparin to a client following knee replacement surgery to prevent a deep vein thrombosis. Which laboratory result requires immediate action by the nurse?

Reference Range:

Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)] Platelets [150,000 to 400,000/mm3 (150 to 400 x 109/L]] Creatinine [0.5 to 1.1 mg/dL (44 to 97 pmol/L)]

Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

A. "I need to notify my healthcare provider if I lose my appetite or get nauseated." This statement shows understanding because loss of appetite and nausea can be symptoms of digoxin toxicity or side effects, and it is important to report these symptoms to a healthcare provider. Monitoring for such side effects is crucial when taking digoxin.
B. "I should take my furosemide only if I have shortness of breath or swelling in my feet." This statement is incorrect because furosemide, a diuretic, should be taken according to the prescribed schedule, not based on symptoms. It is used to manage fluid retention and symptoms of heart failure, and its use should not be dependent solely on the presence of symptoms.
C. "I need to check my blood pressure three times a day." While monitoring blood pressure is important, it is not specifically required for patients on digoxin and furosemide unless instructed by a healthcare provider. The focus should be more on monitoring for symptoms of drug side effects and electrolyte imbalances.
D. "If I lose more than one pound in a week, I should hold my next dose of furosemide." Weight loss can be a normal effect of furosemide due to fluid loss, and the decision to hold a dose should be based on specific medical advice and not solely on weight change.

A) Avoid the intake of dairy products while using the medication: There is no specific requirement to avoid dairy products when using bulk-forming laxatives. The primary concern with bulk-forming laxatives is to ensure they are taken with adequate fluids.
B) Take the medication one hour after meals and other medications: Bulk-forming laxatives should be taken with a meal or at a different time from other medications to prevent interactions, but the key aspect is to follow the medication with sufficient fluids rather than timing relative to meals.
C) Remain upright for thirty minutes following drug administration: While remaining upright can help prevent potential esophageal irritation, it is not the primary instruction for bulk-forming laxatives. The more critical instruction is related to fluid intake to ensure effectiveness and prevent complications.
D) Follow medication administration with an additional glass of water: Bulk-forming laxatives require adequate fluid intake to function properly. Following the medication with an additional glass of water helps the laxative form a gel-like substance in the intestines, which aids in bowel movement and prevents potential complications like obstruction.