A nurse is caring for a client who has a new prescription for metformin. Which of the following laboratory results should the nurse evaluate prior to administering the first dose?
Potassium level
Creatinine level
Platelet count
Liver enzymes
The Correct Answer is B
Before administering the first dose of metformin, the nurse should evaluate the client's creatinine level. Metformin is primarily excreted by the kidneys, and its clearance from the body depends on the renal function. If the client has impaired kidney function, metformin can accumulate in the body and lead to potential adverse effects, particularly lactic acidosis.
Monitoring the creatinine level helps assess the client's kidney function and determines whether it is safe to administer metformin. If the creatinine level is elevated, indicating reduced kidney function, the nurse should consult with the healthcare provider to determine the appropriate dose adjustment or consider an alternative treatment option.
Let's go through the other options and explain why they are not the priority laboratory results to evaluate before administering metformin:
A. Potassium level: While monitoring potassium levels is important in some situations, it is not a primary concern before administering metformin. Metformin does not have a significant effect on potassium levels, and it is not a medication known for causing hypokalemia (low potassium levels).
C. Platelet count: Metformin does not have a direct impact on platelet count, and evaluating platelet count is not typically required before starting metformin therapy. Platelet count monitoring may be relevant for certain other medications or medical conditions, but it is not specific to metformin administration.
D. Liver enzymes: While it is essential to monitor liver function in clients on long-term metformin therapy, evaluating liver enzymes before the first dose of metformin is not the priority. Metformin is primarily cleared by the kidneys, and liver enzymes are not directly affected by its initial administration. However, ongoing monitoring of liver function may be necessary during long-term
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Related Questions
Correct Answer is D
Explanation
Oxybutynin is an anticholinergic medication commonly used to treat urinary incontinence. One of the adverse effects of anticholinergic medications is the potential for bradycardia, which refers to a slower than normal heart rate. Anticholinergic medications can inhibit the effects of acetylcholine, a neurotransmitter responsible for regulating various bodily functions, including heart rate. Therefore, it is important to assess the client for signs of bradycardia after an unintended higher dose of oxybutynin.
Increased salivation (A) is not an expected adverse effect of oxybutynin. In fact, anticholinergic medications like oxybutynin often have the opposite effect, causing dry mouth and reduced salivation.
Hyperthermia (B) is not a typical adverse effect of oxybutynin. It is more commonly associated with other conditions or medications.
Urinary incontinence (C) is the condition that oxybutynin is intended to treat. It is not an adverse effect but rather the therapeutic effect of the medication.
Correct Answer is A
Explanation
When providing teaching to a client with chronic rheumatoid arthritis who is starting a new prescription for hydroxychloroquine, the nurse should instruct the client to obtain routine eye examinations. Hydroxychloroquine is an antimalarial and immunosuppressive medication commonly used to treat rheumatoid arthritis and other autoimmune conditions.
One of the potential side effects of hydroxychloroquine is ocular toxicity, particularly affecting the retina. Retinal toxicity can lead to vision changes or, in severe cases, irreversible damage to the eyes. Therefore, regular eye examinations are necessary to monitor for any signs of retinal toxicity and detect any visual changes early to prevent further complications.
The American Academy of Ophthalmology recommends that patients taking hydroxychloroquine undergo a baseline eye examination before starting the medication and annual eye examinations thereafter, especially after five years of continuous use.
Let's go through the other options:
B. Chest x-ray: A chest x-ray is not routinely required for monitoring clients taking hydroxychloroquine for rheumatoid arthritis. Hydroxychloroquine is not known to cause significant respiratory or pulmonary side effects.
C. Pancreatic enzyme levels: Monitoring pancreatic enzyme levels is not specifically related to hydroxychloroquine therapy. Pancreatic enzyme level testing is typically used to assess the function of the pancreas in conditions like pancreatitis or pancreatic insufficiency.
D. Urinalysis screening: While regular monitoring of kidney function is important for clients on long-term medication therapy, routine urinalysis screening is not specifically related to hydroxychloroquine use in clients with rheumatoid arthritis. Regular eye examinations are of higher priority due to the potential ocular toxicity associated with this medication.
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