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 B
Explanation
Choice A rationale:
Administering the medication without first assessing the pain could lead to inappropriate medication administration and potentially mask underlying issues. It's crucial to gather more information about the pain before providing any medication.
Choice C rationale:
While repositioning might offer some relief in certain cases, it's not the first step in pain management. A thorough assessment to understand the nature, location, and severity of the pain is essential for determining the most appropriate intervention.
Choice D rationale:
Reviewing the effects of previous pain medication is important, but it doesn't take priority over assessing the current pain. Understanding the current pain experience is necessary to make informed decisions about medication administration and other interventions.
Choice B rationale:
Determining the location of the pain is the crucial first step in pain assessment. It helps to: Identify the potential source of the pain, which can guide treatment choices.
Understand the pain's characteristics, such as its quality, intensity, and duration.
Evaluate for any associated symptoms or patterns, which can provide further insights into the underlying cause. Assess for any aggravating or alleviating factors, which can help tailor treatment strategies.
Monitor the effectiveness of interventions by comparing changes in pain location and characteristics.
Correct Answer is A
Explanation
Choice A rationale:
Magnet activation: Placing a magnet over the implantable device activates an on-demand feature of the VNS, delivering extra stimulation to the vagus nerve. This can potentially disrupt or shorten a seizure, especially when used at the onset of an aura (a warning sign that a seizure may be imminent).
Patient empowerment: Teaching the patient how to use the magnet provides them with a sense of control and a way to actively manage their seizures. It can reduce anxiety and improve quality of life.
Choice B rationale:
Microwave safety: While there's no definitive evidence that microwaves directly interfere with VNS devices, manufacturers generally recommend avoiding close or prolonged exposure to microwaves as a precaution. Specific guidelines may vary, but they often suggest keeping a distance of at least 15-20 inches from microwaves. The statement in Choice B about 12,000 watts or less is inaccurate and misleading.
Choice C rationale:
CT scans with contrast: There's no contraindication for patients with VNS to undergo CT scans with contrast. The device is designed to withstand common imaging procedures.
Choice D rationale:
Pain management: Burst catheters are typically used for pain management after surgery or during childbirth. They have no direct relevance to VNS therapy or seizure management.
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