The nurse is caring for a client who is taking diclofenac, a nonsteroidal anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review?
Glucose.
Total protein.
Sodium.
Hemoglobin.
The Correct Answer is D
Choice A reason: This is not the most important laboratory value for the nurse to review. Glucose is a measure of blood sugar levels, and it may be affected by various factors, such as diet, medication, stress, or infection. However, glucose is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the glucose levels for any changes, but it is not the priority.
Choice B reason: This is not the most important laboratory value for the nurse to review. Total protein is a measure of the amount of protein in the blood, and it may reflect the nutritional status, liver function, or kidney function of the client. However, total protein is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the total protein levels for any changes, but it is not the priority.
Choice C reason: This is not the most important laboratory value for the nurse to review. Sodium is a measure of the electrolyte balance in the blood, and it may be affected by fluid intake, fluid loss, or hormonal regulation. However, sodium is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the sodium levels for any changes, but it is not the priority.
Choice D reason: This is the most important laboratory value for the nurse to review. Hemoglobin is a measure of the oxygen-carrying capacity of the blood, and it may indicate the presence of anemia, which is a common adverse effect of diclofenac. Diclofenac can cause gastrointestinal bleeding, which can lead to a decrease in hemoglobin and hematocrit levels. The client's appearance and fatigue may be signs of anemia, which can impair the tissue oxygenation and worsen the client's condition. The nurse should review the hemoglobin levels and report any abnormal findings to the healthcare provider. The nurse should also assess the client for other signs of bleeding, such as melena, hematemesis, or hematuria.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: This is the highest priority action for the nurse to take. Codeine is an opioid analgesic that can cause drowsiness, dizziness, and impaired coordination. These effects can increase the risk of falls and injuries in the client, especially when ambulating to the bathroom. The nurse should instruct the client to request assistance when getting out of bed or walking, and provide adequate support and supervision.
Choice B reason: This is not the highest priority action for the nurse to take. Administering a stool softener/laxative at the same time as the analgesic is a preventive measure that can help reduce the risk of constipation, which is a common side effect of codeine. However, this action is not as urgent or important as ensuring the client's safety and preventing falls.
Choice C reason: This is not the highest priority action for the nurse to take. Advising the client that the medication should start to work in about 30 minutes is an informative and reassuring measure that can help the client cope with pain and anxiety. However, this action is not as urgent or important as ensuring the client's safety and preventing falls.
Choice D reason: This is not the highest priority action for the nurse to take. Telling the client to notify the nurse if the pain is not relieved is an evaluative and responsive measure that can help the nurse monitor the effectiveness of the analgesic and adjust the dosage or frequency as needed. However, this action is not as urgent or important as ensuring the client's safety and preventing falls.
Correct Answer is C
Explanation
Choice A reason: Antacids can interfere with the absorption of cimetidine. It is generally recommended to avoid taking antacids within 1 hour before or after taking cimetidine to ensure optimal absorption. Therefore, taking cimetidine an hour after antacids is appropriate.
Choice B reason: Notifying the healthcare provider of lethargy is a correct statement, as it may indicate a serious side effect of cimetidine. Cimetidine can cause central nervous system effects, such as confusion, drowsiness, headache, and depression. Lethargy may also be a sign of anemia, which is another possible side effect of cimetidine. The nurse should instruct the client to report any unusual symptoms to the healthcare provider and monitor the client's blood count and liver function.
Choice C reason:Smoking has been shown to impair the effectiveness of cimetidine in treating ulcers and can delay healing. The goal should be complete smoking cessation rather than merely reducing cigarette use. Therefore, the statement about decreasing cigarette use to a pack per day indicates a misunderstanding and requires additional instruction by the nurse.
Choice D reason: Monitoring for any signs of sexual dysfunction is a correct statement, as it may indicate another side effect of cimetidine. Cimetidine can cause endocrine effects, such as gynecomastia, impotence, and decreased libido in men, and menstrual irregularities in women. The nurse should instruct the client to inform the healthcare provider if they experience any changes in their sexual function or reproductive health.
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