A nurse is reviewing a new prescription for a client. The nurse should identify that which of the following abbreviations used by the provider indicates “to administer medications before meals”?

A. "This test shows if I am dehydrated." aPTT is not used to assess hydration status; it measures blood clotting ability.

B. "This test measures deficiencies in clotting factors." aPTT assesses the intrinsic clotting pathway and helps evaluate clotting factor deficiencies, especially in conditions like hemophilia or when a client is on heparin therapy.

C. "If my level is too low, I need to consume more sodium." Sodium intake does not directly impact aPTT values.

D. "The aPTT is used to measure my sugar levels." Glucose levels are measured by a blood sugar test, not an aPTT test.

Here is the rationale for each choice:

A. HbA1C 5.9%: HbA1C is a measure of long-term glucose control in patients, often used in diabetes management. A value of 5.9% is slightly above the normal range (4–5.7%) but does not indicate hepatotoxicity.

B. Albumin 3.8 g/dl: Albumin is a protein produced by the liver, and its levels can reflect liver function. A normal range is 3.5–5 g/dl, and 3.8 g/dl falls within this range. Thus, it does not indicate hepatotoxicity.

C. Alanine aminotransferase (ALT) 67 units/l: ALT is an enzyme primarily found in the liver and is a key marker for liver injury. The normal range for ALT is approximately 7–56 units/l. A value of 67 units/l is slightly elevated, which may suggest mild liver damage or hepatotoxicity. This result should be reported to the provider, as it could be associated with the medication’s impact on the liver.

D. Aspartate aminotransferase (AST) 39 units/l: AST is another enzyme used to evaluate liver function, though it is less specific to the liver than ALT, as AST is also found in other tissues such as the heart and muscles. The normal range for AST is roughly 10–40 units/l.