A nurse is reviewing laboratory results for a client who has been taking amoxicillin-clavulanate (Augmentin) for a bacterial respiratory tract infection.
Which of the following findings should alert the nurse to a possible adverse effect of this medication? (Select all that apply.).
Elevated serum creatinine level.
Elevated serum alanine aminotransferase level.
Elevated serum potassium level.
Elevated white blood cell count.
Correct Answer : A,B,D
Choice A rationale:
An elevated serum creatinine level can indicate kidney dysfunction or damage, which can be a possible adverse effect of amoxicillin-clavulanate. The kidneys are responsible for excreting the medication, and elevated creatinine levels suggest impaired renal function.
Choice B rationale:
An elevated serum alanine aminotransferase (ALT) level is indicative of liver dysfunction or damage. Amoxicillin-clavulanate can sometimes cause hepatotoxicity as a side effect, and elevated ALT levels may suggest this adverse effect.
Choice D rationale:
An elevated white blood cell count (leukocytosis) can be a possible adverse effect of amoxicillin-clavulanate, indicating an increase in the body's immune response. This could be due to an allergic reaction or other adverse reactions to the medication.
Choice C rationale:
An elevated serum potassium level is not typically associated with amoxicillin-clavulanate use. This finding is more likely related to other factors such as kidney dysfunction or certain medications like potassium-sparing diuretics.
Choice E rationale:
An elevated platelet count is not typically associated with amoxicillin-clavulanate use. This finding is more likely related to other factors, such as a bone marrow disorder or inflammation.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale:
4012 mg/day is not the correct answer. To calculate the maximum safe dosage of valproic acid, you need to convert the client's weight from pounds to kilograms. The client's weight in kilograms can be calculated by dividing the weight in pounds by 2.2. Therefore, 176 pounds divided by 2.2 equals 80 kilograms. The maximum safe dosage is 60 mg/kg/day, so 60 mg multiplied by 80 kg equals 4800 mg/day.
Choice B rationale:
Step 1: Convert the client’s weight from pounds to kilograms. We know that 1 kg is approximately equal to 2.2 pounds. So, we have:
176 pounds ÷ 2.2 = 80 kg (approximately)
Step 2: Calculate the maximum safe dosage for the client. We know that the maximum safe dosage of valproic acid is 60 mg/kg/day. So, we have:
60 mg/kg/day × 80 kg = 4800 mg/day
So, the maximum safe dosage for a client who weighs 176 pounds is4800 mg/day.
Choice C rationale:
3520 mg/day is not the correct answer. It does not accurately calculate the maximum safe dosage based on the client's weight.
Choice D rationale:
6171 mg/day is not the correct answer. It is significantly higher than the correct calculation and would exceed the maximum safe dosage for the client's weight.
Correct Answer is D
Explanation
This is the correct answer because BUN and creatinine are the most important laboratory values to monitor for nephrotoxicity, which is the damage or injury to the kidneys caused by certain drugs or chemicals.
Nephrotoxicity can impair the kidneys' ability to filter waste products from the blood, resulting in elevated levels of BUN and creatinine. The normal range for BUN is 7 to 20 mg/dL, and for creatinine is 0.6 to 1.2 mg/dL. The practical nurse (PN) should review these values before administering an antibiotic that can cause nephrotoxicity, such as aminoglycosides, cephalosporins, vancomycin, or sulfonamides. The PN should also monitor the client for signs and symptoms of nephrotoxicity, such as decreased urine output, edema, hypertension, fatigue, nausea, and confusion.
a) Serum calcium
This is not the correct answer because serum calcium is not directly related to nephrotoxicity. Serum calcium is the amount of calcium in the blood, which is important for bone health, muscle contraction, nerve function, and blood clotting. The normal range for serum calcium is 8.5 to 10.2 mg/dL. Serum calcium may be affected by kidney disease, but it is not a reliable indicator of nephrotoxicity.
b) Hemoglobin and hematocrit
This is not the correct answer because hemoglobin and hematocrit are not directly related to nephrotoxicity. Hemoglobin is the protein in red blood cells that carries oxygen, and hematocrit is the percentage of red blood cells in the blood. The normal range for hemoglobin is 13.5 to 17.5 g/dL for men and 12 to 15.5 g/dL for women, and for hematocrit is 38.8 to 50% for men and 34.9 to 44.5% for women.
Hemoglobin and hematocrit may be affected by kidney disease, but they are not reliable indicators of
nephrotoxicity.
c) White blood cell count (WBC)
This is not the correct answer because WBC is not directly related to nephrotoxicity. WBC is the number of white blood cells in the blood, which are part of the immune system and fight infections. The normal range for WBC is 4,500 to 10,000 cells per microliter of blood. WBC may be elevated in response to an infection or inflammation, but it is not a reliable indicator of nephrotoxicity.
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