The nurse is preparing to administer alendronate to a client with osteoporosis. Which laboratory value indicates that the nurse should withhold the medication and contact the healthcare provider?

Reference Range:

Total Calcium (9 to 10.5 mg/dL (2.3 to 2.6 mmol/L)]

Sodium [136 to 145 mEq/L (136 to 145 mmol/L)]

Potassium [3.5 to 5 mEq/L (3.5 to 5 mmol/L)]

Magnesium [1.3 to 2.1 mEq/L (0.65 to 1.05 mmol/L)]

Calcium 13.0 mg/dL (3.3 mmol/L).

Magnesium 2.4 mEq/L (2.4 mmol/L).

Potassium 5.2 mEq/L (5.2 mmol/L).

Sodium 132 mEq/L (132 mmol/L)

Answer and Explanation

The Correct Answer is A

A. Calcium 13.0 mg/dL (3.3 mmol/L): Alendronate is used to inhibit bone resorption and is typically prescribed when calcium levels are normal. A high calcium level suggests hypercalcemia, which could worsen if alendronate is given. Therefore, the medication should be withheld, and the healthcare provider must be notified for further evaluation.

B. Magnesium 2.4 mEq/L (2.4 mmol/L): This magnesium level is slightly elevated but is not critically abnormal. Magnesium levels are not a primary consideration when deciding whether to administer alendronate, and this finding alone would not necessitate withholding the medication.

C. Potassium 5.2 mEq/L (5.2 mmol/L): Mild hyperkalemia is noted here, but potassium levels do not directly impact the safety or effectiveness of alendronate. The nurse should monitor it but does not need to withhold alendronate based on this finding.

D. Sodium 132 mEq/L (132 mmol/L): This value indicates mild hyponatremia, but sodium abnormalities are not a direct contraindication to alendronate therapy. The medication could still be administered while addressing the sodium imbalance separately.

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Free Nursing Study Resources

Correct Answer is D

Explanation

A. Sodium: Monitoring sodium is important in many conditions, but diclofenac, a nonsteroidal anti-inflammatory drug (NSAID), is more commonly associated with gastrointestinal bleeding rather than causing significant electrolyte imbalances like hyponatremia. Sodium levels are not the primary concern in this scenario.

B. Glucose: Blood glucose monitoring is critical for clients with diabetes or corticosteroid use, but diclofenac is not known to directly impact glucose metabolism. Reviewing glucose levels would not immediately address the symptoms of pallor and fatigue.

C. Total protein: Total protein levels reflect nutritional and liver status but are not the best marker for acute blood loss or anemia. Changes in total protein would not directly explain symptoms like pallor and fatigue related to NSAID complications.

D. Hemoglobin: Diclofenac can cause gastrointestinal irritation and occult bleeding, leading to anemia. Pallor and fatigue are classic symptoms of low hemoglobin levels, making it the most important laboratory value to review to evaluate for possible GI bleeding and anemia.

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D","dropdown-group-3":"A"}

Explanation

Increasing heart rate: Increasing heart rate is not the mechanism of thiazide diuretics or ACE inhibitors. It would raise blood pressure by increasing cardiac workload. Effective antihypertensives aim to lower or stabilize heart rate, not increase it.
Reducing stroke volume: Thiazide diuretics reduce stroke volume by lowering blood volume through sodium and water excretion. This decreases cardiac output and helps lower blood pressure, particularly in volume-sensitive hypertension.
Suppressing the appetite: Suppressing appetite is unrelated to the action of thiazide diuretics or ACE inhibitors. These drugs target fluid balance and vascular tone, not the central nervous system mechanisms that regulate hunger.
Decreasing serum sodium levels: Both thiazide diuretics and ACE inhibitors contribute to decreased serum sodium levels, which helps lower blood volume. This reduction supports blood pressure control but must be monitored to avoid hyponatremia.
Reducing systemic vascular resistance: ACE inhibitors lower blood pressure by reducing systemic vascular resistance through vasodilation. Blocking angiotensin II prevents arterial constriction, easing the workload on the heart and lowering afterload.

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client who is taking diclofenac 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?

Correct Answer is D

Explanation

Patient Data Select from Word Choices to complete the sentence. The thiazide diuretic works to decrease the client's blood pressure by ______, and the angiotensin converting enyzme (ACE) inhibitor works to decrease the client's blood pressure by ________ and _______

Correct Answer is {"dropdown-group-1":"B","dropdown-group-2":"D","dropdown-group-3":"A"}

Explanation

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