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 is incorrect. While keeping the bed in a high position can minimize fall risk, it is not a specific precaution for preventing seizures. In fact, some types of seizures can be triggered by sudden changes in position.
Choice C is incorrect. Bright lights can worsen seizure activity and should be avoided, especially during the night when the client is more likely to be photosensitive.
Choice D is incorrect. Locking the bed in the lowest position can increase fall risk and is not a specific precaution for preventing seizures.
Rationale for Choice B:
Having seizure medication readily available at the bedside allows for immediate administration in case of a seizure, which can minimize its duration and severity. This is a crucial intervention for seizure precaution.
Keeping the medication within easy reach also ensures prompt administration by healthcare personnel or caregivers, further improving the client's safety and outcome.
Additionally, easy access to the medication empowers the client or caregiver to participate actively in their own care and respond quickly to a potential seizure.
Therefore, based on the importance of immediate access to seizure medication in managing and preventing seizures, Choice B is the most appropriate intervention to include in the client's plan of care.
Correct Answer is C
Explanation
Choice A rationale:
Holding the client's arms and legs from moving during a seizure can actually cause injury to the client or the nurse. The forceful muscle contractions that occur during a seizure can cause bones to break or joints to dislocate. Additionally, trying to restrain the client can increase their agitation and make the seizure worse.
Choice B rationale:
Placing the client back in bed during a seizure is not safe. The client could fall out of bed and injure themselves. It is also important to allow the client to have space to move freely during the seizure to prevent injury.
Choice C rationale:
Placing the client on their side is the safest position for a client who is having a seizure. This position helps to protect the airway and prevent aspiration. It also allows any fluids or secretions to drain out of the mouth, which can help prevent choking.
Choice D rationale:
Inserting a tongue blade into the client's mouth during a seizure is not recommended. It is a common misconception that people can swallow their tongue during a seizure. This is not possible. Inserting a tongue blade can actually cause more harm than good. It can break teeth, damage the mouth, or even block the airway.
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