A male client is admitted for observation because he is reporting progressively increasing fatigue over the past month and a brief episode of dizziness that occurred today. He has a history of heartburn and indigestion that he self-treats with ibuprofen and antacids. Which assessment finding should the nurse report immediately to the healthcare provider?

Reference Ranges:
Hemoglobin (14 to 18 g/dL (8.7 to 11.2 mmol/L)]
Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]
Gastric pH [1.5 to 3.5]

Hematocrit 42% (0.42 volume fraction).

Hemoglobin 13 g/dL (8.07 mmol/L).

Positive guaiac of stool.

Gastric pH 2.0.

Answer and Explanation

The Correct Answer is C

A. Hematocrit 42% (0.42 volume fraction):
A hematocrit of 42% is within the normal reference range for males (42% to 52%). While it is important to monitor hematocrit levels, this finding alone does not indicate an immediate issue.

B. Hemoglobin 13 g/dL (8.07 mmol/L):
A hemoglobin level of 13 g/dL is slightly below the normal range for males (14 to 18 g/dL). However, it is not critically low and may not require immediate intervention without additional context or symptoms.

C. Positive guaiac of stool:
A positive guaiac test for stool indicates the presence of occult blood in the stool, which could suggest gastrointestinal bleeding. Given the client's history of heartburn, indigestion, and use of ibuprofen (a nonsteroidal anti-inflammatory drug that can cause gastrointestinal bleeding), this finding is concerning and should be reported immediately to the healthcare provider for further evaluation and management.

D. Gastric pH 2.0:
A gastric pH of 2.0 is within the normal range for gastric acid, as the normal pH of gastric acid typically ranges from 1.5 to 3.5. This finding is expected and does not indicate an immediate problem related to the client's symptoms.

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Correct Answer is B

Explanation

A. Monitor the client's serum electrolytes:
Amlodipine, a calcium channel blocker, primarily affects blood pressure and not directly electrolyte levels. Monitoring electrolytes is more relevant for medications that affect electrolyte balance, such as diuretics or certain antihypertensives.

B. Measure the client's blood pressure:
Amlodipine is used to treat hypertension and angina by relaxing blood vessels. The primary measure of its effectiveness is the reduction in blood pressure. Therefore, measuring the client’s blood pressure is crucial to assess whether the medication is effectively managing hypertension.

C. Review the client's intake and output:
While monitoring intake and output is important for assessing fluid balance and kidney function, it is not the primary method for evaluating the effectiveness of amlodipine in controlling blood pressure.

D. Note the client's serum calcium levels:
Amlodipine affects calcium channels but does not directly influence serum calcium levels significantly. Serum calcium levels are not used to assess the effectiveness of amlodipine in treating hypertension or angina.

A. Avoid prolonged exposure to direct sunlight. B. Stop the oral contraceptive immediately. C. Take the medications at least 12 hours apart. D. Use an additional form of contraception.

Correct Answer is D

Explanation

A) Avoid prolonged exposure to direct sunlight: While erythromycin can increase sensitivity to sunlight, this is not directly related to the interaction between oral contraceptives and erythromycin. The primary concern with erythromycin and oral contraceptives is their interaction rather than sun exposure.

B) Stop the oral contraceptive immediately: There is no need to stop oral contraceptives when taking erythromycin. However, erythromycin can potentially reduce the effectiveness of oral contraceptives, so additional precautions should be taken rather than discontinuing the contraceptive.

C) Take the medications at least 12 hours apart: Timing of administration is not a primary concern for this interaction. The main issue is the potential reduction in contraceptive efficacy rather than timing the doses of the medications.

D) Use an additional form of contraception: Erythromycin can potentially decrease the effectiveness of oral contraceptives due to its effect on liver enzymes and drug metabolism. It is advisable to use an additional form of contraception to prevent unintended pregnancy while taking erythromycin.

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Naxlex Comprehensive Predictor Exams

Which action should the nurse implement to assess the effectiveness of amlodipine?

Correct Answer is B

Explanation

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Correct Answer is D

Explanation

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