A nurse is caring for an older adult client who is taking prednisone for long-term treatment of rheumatoid arthritis.
The nurse should monitor the client for which of the following adverse effects of this drug?

Metformin is an antidiabetic agent used to treat type 2 diabetes mellitus.

It works by decreasing carbohydrate absorption from the gut, increasing glucose uptake in peripheral tissues in the presence of insulin, and reducing hepatic gluconeogenesis.

In normal patients, metformin ingestion is not associated with hypoglycemia.

However, it is still important to check the client’s glucose level to ensure that it is within a safe range.

Choice A is wrong because collecting the client’s uric acid level is not necessary after accidental administration of metformin.

Choice B is wrong because obtaining the client’s HDL level is not necessary after accidental administration of metformin.

Choice D is wrong because monitoring the client’s thyroid function levels is not necessary after accidental administration of metformin.

The correct answer is Choice B.

Choice A rationale:

Documenting the administration of the medication is crucial for maintaining accurate records and ensuring accountability. However, it is not the first action to take. The priority is to ensure the correct patient receives the correct medication.

Choice B rationale:

Identifying the client using two identifiers is the first and most critical step. This action ensures that the right patient receives the right medication, thereby minimizing the risk of medication errors.

Choice C rationale:

Comparing the amount of medication available to the inventory record is important for maintaining accurate inventory and preventing misuse or theft of controlled substances. However, this is not the first step in the process of administering medication to a patient in pain.

Choice D rationale:

Removing the medication from the medication dispensing cabinet is part of the process, but it should only be done after the patient has been properly identified to avoid any potential errors.