A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which of the following laboratory values indicates an adverse effect of this medication?

BUN 15 mg/dL

WBC 3,000/mm

Hct 45%

Platelets 250,000/mm

Answer and Explanation

The Correct Answer is B

Choice A Reason:
BUN 15 mg/dL (blood urea nitrogen) is incorrect. An elevated BUN level can indicate kidney dysfunction or dehydration, but it's not typically associated with azathioprine's adverse effects. Azathioprine is known to affect bone marrow, leading to decreased blood cell counts, rather than directly impacting kidney function.
Choice B Reason:
WBC 3,000/mm³ (low white blood cell count) is correct. Azathioprine is an immunosuppressive medication used to treat various conditions, including rheumatoid arthritis. One of its known adverse effects is bone marrow suppression, which can lead to decreased production of blood cells, including white blood cells (WBCs). A low WBC count (leukopenia) can increase the risk of infections due to compromised immune function, making it an important adverse effect to monitor in individuals taking azathioprine.
Choice C Reason:
Hct 45% (hematocrit) is incorrect. A hematocrit of 45% is within the normal range for both men and women. Azathioprine adverse effects usually manifest as blood cell-related issues (such as leukopenia) rather than directly impacting hematocrit levels.
Choice D Reason:
Platelets 250,000/mm³: Platelets within the range of 150,000 to 400,000/mm³ are considered normal. Azathioprine typically affects white blood cells more prominently than platelet counts.

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Correct Answer is D

Explanation

Choice A Reason:
Decrease the dose of the medication is incorrect. Lowering the dose could potentially drop the INR below the therapeutic range, increasing the risk of clot formation.
Choice B Reason:
Increase the dose of the medication is incorrect. Raising the dose might push the INR above the therapeutic range, increasing the risk of bleeding.
Choice C Reason:
Withhold the medication is incorrect. Withholding the medication might lead to inadequate anticoagulation and an increased risk of clot formation.
Choice D Reason:
Administer the current dose of the medication. An INR of 2.5 is within the therapeutic range for many indications, including atrial fibrillation. This means the blood is appropriately anticoagulated to prevent clot formation without an excessive risk of bleeding. In this scenario, maintaining the current dose of warfarin is often appropriate to sustain the desired therapeutic effect.

A. "I will check the client's INR before administering the heparin." B. "I will aspirate before administering the heparin." C. "I will massage the site after the injecting the heparin." D. "I will apply pressure for 1 minute after the injection."

Correct Answer is D

Explanation

Choice A Reason:
. "I will check the client's INR before administering the heparin." Is incorrect. Checking the client's INR (International Normalized Ratio) is essential, but it's more applicable for monitoring anticoagulants like warfarin, not heparin. Heparin's effect is typically monitored via activated partial thromboplastin time (aPTT) or anti-Xa levels, not INR.
Choice B Reason:
"I will aspirate before administering the heparin." Is incorrect. Aspirating before administering heparin injections is not necessary because the medication is given subcutaneously or intravenously and not into a blood vessel.
Choice C Reason:
"I will massage the site after injecting the heparin." Is incorrect. Massaging the site after injecting heparin could increase the risk of bruising or hematoma formation at the injection site. It's generally advised to avoid massaging the area after a heparin injection to prevent tissue trauma.
Choice D Reason:
"I will apply pressure for 1 minute after the injection." Is correct. Applying pressure to the injection site for about a minute after administering heparin helps minimize the risk of bleeding or hematoma formation, especially with subcutaneous injections. This practice aids in reducing bleeding at the injection site.

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A nurse is caring for a client who is taking azathioprine to treat rheumatoid arthritis. Which of the following laboratory values indicates an adverse effect of this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is D

Explanation

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