A client taking atorvastatin develops an increased serum creatine phosphokinase (CK) level. The nurse should assess the client for the onset of which problem?
Peripheral edema.
Muscle tenderness.
Nausea and vomiting.
Excessive bruising.
The Correct Answer is B
Choice A reason: Peripheral edema is not a common side effect of atorvastatin, and it is not related to increased CK levels. CK is an enzyme that is released when muscle tissue is damaged. Peripheral edema is more likely to be caused by heart failure, kidney disease, or venous insufficiency.
Choice B reason: Muscle tenderness is a sign of myopathy, which is a rare but serious adverse effect of atorvastatin. Myopathy is a condition where muscle fibers are damaged and inflamed, leading to muscle weakness and pain. Increased CK levels indicate muscle injury and can be a marker of myopathy. The nurse should monitor the client for muscle symptoms and report them to the prescriber.
Choice C reason: Nausea and vomiting are common gastrointestinal side effects of atorvastatin, but they are not associated with increased CK levels. Nausea and vomiting can be managed by taking the medication with food or reducing the dose.
Choice D reason: Excessive bruising is not a typical side effect of atorvastatin, and it is not linked to increased CK levels. Excessive bruising can be caused by bleeding disorders, anticoagulant therapy, or trauma. The nurse should assess the client for other signs of bleeding, such as hematuria, hematemesis, or melena.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: A bladder scan is used to measure the post-void residual urine volume, which can indicate urinary retention. It is not related to the adverse effects of tamsulosin.
Choice B reason: Assessing urine output is important for clients with urinary problems, but it is not specific to the adverse effects of tamsulosin.
Choice C reason: Tamsulosin is an alpha-blocker that relaxes the smooth muscles of the prostate and bladder neck, improving urine flow. However, it can also cause hypotension, dizziness, and fainting as adverse effects. Therefore, monitoring blood pressure is essential for clients taking tamsulosin.
Choice D reason: Obtaining daily weights is not relevant to the adverse effects of tamsulosin. It is more useful for clients with fluid retention or edema.
Correct Answer is D
Explanation
Choice A reason: Assessing for orthostatic hypotension before administering the dose is not necessary, as labetalol does not cause orthostatic hypotension. Orthostatic hypotension is a condition where the blood pressure drops significantly when changing positions from lying to sitting or standing. Labetalol is a beta-blocker that lowers blood pressure by reducing the heart rate and cardiac output.
Choice B reason: Administering the dose and monitoring the client's B/P regularly is not appropriate, as labetalol may cause further bradycardia (slow heart rate) in this client. The client's heart rate is already below normal (48 beats/minute), which may indicate that labetalol is overdosed or contraindicated. Bradycardia can lead to decreased perfusion, dizziness, fatigue, and fainting.
Choice C reason: Applying a telemetry monitor before administering the dose is not sufficient, as labetalol may cause serious cardiac arrhythmias (irregular heart rhythms) in this client. The client's heart rate is already below normal (48 beats/minute), which may indicate that labetalol is affecting the electrical conduction system of the heart. Arrhythmias can cause palpitations, chest pain, shortness of breath, and cardiac arrest.
Choice D reason: Withholding the scheduled dose and notifying the healthcare provider is the best action for the nurse to take in this situation. The client's heart rate is already below normal (48 beats/minute), which may indicate that labetalol is causing adverse effects or interactions with other medications. The healthcare provider should be informed of the client's vital signs and medication history, and decide whether to adjust or discontinue labetalol.
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