To prevent deep vein thromboses following knee replacement surgery, an adult male client is receiving daily subcutaneous enoxaparin. 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/mm² (150 to 400 × 10^9/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)]
Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Choice A reason: Midmorning is not a likely time for experiencing hypoglycemia after administering glargine insulin at 0800, because glargine insulin has a slow onset of action (about 1 hour) and does not have a pronounced peak effect. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

Choice B reason: No peak occurs is the correct answer for when hypoglycemia is most likely to occur after administering glargine insulin at 0800, because glargine insulin does not have a pronounced peak effect that could cause a sudden drop in blood glucose levels. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

Choice C reason: Midafternoon is not a likely time for experiencing hypoglycemia after administering glargine insulin at 0800, because glargine insulin has a long duration of action (about 24 hours) and does not have a pronounced peak effect. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

Choice D reason: Shortly after midnight is not a likely time for experiencing hypoglycemia after administering glargine insulin at 0800, because glargine insulin has a long duration of action (about 24 hours) and does not have a pronounced peak effect. Glargine insulin is a long-acting insulin that provides a steady level of insulin throughout the day and night.

Choice A reason: Increased anxiety and nervousness have been reported by some people taking feverfew, but this is not a common or serious side effect. It may be related to individual sensitivity or dosage.

Choice B reason: Feverfew may interact with aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, which are commonly used for pain relief. Feverfew and these drugs can both inhibit platelet aggregation and increase the risk of bleeding. This information is most important for the nurse to include in a teaching plan for this client, especially if they are taking any of these medications or have a history of bleeding disorders.

Choice C reason: Those with allergies to chamomile, ragweed, or yarrow should not take feverfew, because they may have a cross-reactivity and experience an allergic reaction to feverfew. This information is important for the nurse to include in a teaching plan for this client, but it is not as critical as choice B.

Choice D reason: Abdominal pain, gas, nausea, vomiting, and diarrhea can occur when taking feverfew, but these are usually mild and transient side effects that do not require medical attention. They may be reduced by taking feverfew with food or water.