A nurse is caring for a patient with rheumatoid arthritis. The patient is prescribed hydroxychloroquine to slow the progression of the disease. Which of the following laboratory results should the nurse monitor for this patient?
Decreased white blood cell count
Increased blood cell count
Decreased platelet count
Increased red blood cell count
The Correct Answer is A
Choice A rationale:
Hydroxychloroquine can cause a rare but serious side effect called bone marrow suppression. This is a decrease in the production of blood cells in the bone marrow.
White blood cells (WBCs) are a key component of the immune system, and a decrease in WBCs can make a patient more susceptible to infections.
Therefore, it's crucial for nurses to monitor the patient's WBC count to detect any potential bone marrow suppression early and take necessary actions to prevent or manage infections.
Choice B rationale:
An increased blood cell count is not a typical side effect of hydroxychloroquine.
Some conditions, like polycythemia vera, can cause an increase in blood cell count, but they are not related to hydroxychloroquine use.
Choice C rationale:
While hydroxychloroquine can sometimes cause a decrease in platelet count, it's less common than bone marrow suppression affecting WBCs.
However, it's still essential for nurses to monitor platelet counts as well, as a significantly low platelet count can impair blood clotting and increase the risk of bleeding.
Choice D rationale:
Hydroxychloroquine does not typically affect red blood cell (RBC) counts.
Conditions that affect RBC counts, such as anemia, are not directly related to hydroxychloroquine use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale:
While inquiring about pre-seizure symptoms can be informative, it's not the most crucial question at this point. The priority is to gather information about medication adherence to assess potential causes for the breakthrough seizure.
Choice B rationale:
Assessing for post-ictal fatigue is important, but it's not the most pressing question in the immediate aftermath of a seizure. Determining medication adherence takes precedence.
Choice D rationale:
Establishing whether consciousness was lost can aid in classifying seizure type, but it's not as critical as understanding medication adherence in the initial assessment.
Choice C rationale:
This question directly addresses a potential cause of the seizure. Understanding when the client last took their medication can help determine if missed or delayed doses contributed to the seizure, guide medication adjustments, and inform further seizure prevention strategies.
Correct Answer is A
Explanation
Choice A rationale:
Fever is the most reliable early indicator of infection in a client with low WBC because it is a direct physiologic response to the presence of pathogens. When the body detects an infection, it releases pyrogens, which act on the hypothalamus to raise the body's temperature. This elevated temperature helps to create an environment that is less hospitable to bacteria and viruses, and it also stimulates the immune system to fight the infection.
In clients with low WBC, the immune system is already compromised, so the fever response may be even more pronounced. It's important to note that even a slight elevation in temperature (as low as 100.4°F or 38°C) can be significant in these clients.
Choice B rationale:
Chills can also be a sign of infection, but they are not as specific as fever. Chills can occur for other reasons, such as exposure to cold or anxiety.
Choice C rationale:
Tachycardia, or increased heart rate, can also be a sign of infection, but it is not as reliable as fever. Tachycardia can occur for other reasons, such as dehydration, pain, or anxiety.
Choice D rationale:
Dyspnea, or shortness of breath, is not a typical early sign of infection. It is more likely to occur in later stages of infection, when the infection has spread to the lungs.
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