A client reports confusion and blurred vision after receiving a dose of glipizide. Which action should the nurse implement?

Choice A reason: Employed as a construction worker is not the most important assessment finding for the nurse to address. Although the client's occupation may expose them to moist and warm environments that can promote fungal growth, it is not directly related to the administration of terbinafine HCL. The nurse should advise the client to wear breathable shoes and socks and keep the feet dry and clean, but it is not a priority.

Choice B reason: Reported history of alcoholism is the most important assessment finding for the nurse to address. Terbinafine HCL can cause hepatotoxicity, especially in clients with pre-existing liver disease or who consume alcohol regularly. The nurse should assess the client's liver function tests and alcohol intake before starting the medication and inform the prescriber accordingly. The nurse should also monitor the client for signs and symptoms of liver damage, such as jaundice, abdominal pain, nausea, or fatigue.

Choice C reason: White blood cell count of 8,500/mm3 (8.5 x 10^9/L) is not the most important assessment finding for the nurse to address. This value is within the normal reference range of 5,000 to 10,000/mm3 (5 to 10 x 10^9/L) and does not indicate any infection or inflammation. The nurse should check the client's baseline blood counts before starting the medication, but it is not a priority.

Choice D reason: Toenails appear thick and yellow is not the most important assessment finding for the nurse to address. This is a typical manifestation of a fungal toenail infection, which is the indication for terbinafine HCL. The nurse should expect the toenails to improve in appearance and texture after the completion of the treatment, which may take several weeks or months. The nurse should educate the client about the expected outcomes and adherence to the medication regimen, but it is not a priority.

Choice A reason: A basic metabolic panel is a blood test that measures the levels of electrolytes, glucose, blood urea nitrogen, creatinine, and calcium in the body. It can be used to assess the fluid balance, kidney function, and acid-base balance of the client. However, it does not provide information about the liver function, which is the most likely cause of the client's symptoms.

Choice B reason: A thyroid function test is a blood test that measures the levels of thyroid hormones and thyroid-stimulating hormone in the body. It can be used to diagnose thyroid disorders, such as hypothyroidism or hyperthyroidism, which can affect the metabolism, energy, and mood of the client. However, it does not provide information about the liver function, which is the most likely cause of the client's symptoms.

Choice C reason: A renal function panel is a blood test that measures the levels of creatinine, blood urea nitrogen, and uric acid in the body. It can be used to assess the kidney function and the excretion of waste products from the body. However, it does not provide information about the liver function, which is the most likely cause of the client's symptoms.

Choice D reason: A liver function test is a blood test that measures the levels of enzymes, proteins, and bilirubin in the body. It can be used to assess the liver function and the production and metabolism of bile. Albendazole is a medication that can cause liver toxicity and hepatitis, which can lead to symptoms such as fatigue, nausea, dark urine, and jaundice. The nurse should review the liver function test to monitor the client's liver status and adjust the medication dose accordingly.