A nurse is reviewing laboratory results of a client who has schizophrenia and is taking risperidone. For which of the following findings should the nurse notify the provider?
Blood glucose 256 mg/dL (74 to 106 mg/dL)
WBC count 6,000/mm³ (5,000 to 10,000/mm³)
Platelets 250,000/mm³ (150,000 to 400,000/mm³)
Sodium 140 mEq/L (136 to 145 mEq/L)
The Correct Answer is A
Choice A reason: A blood glucose level of 256 mg/dL is significantly higher than the normal range and could indicate hyperglycemia, which is a serious side effect of risperidone. The provider should be notified immediately to manage this potential complication.
Choice B reason: A WBC count of 6,000/mm³ is within the normal range and does not typically warrant concern or the need to notify the provider.
Choice C reason: A platelet count of 250,000/mm³ is also within the normal range and is not indicative of an adverse reaction to risperidone.
Choice D reason: A sodium level of 140 mEq/L falls within the normal range and is not a cause for alarm in the context of risperidone therapy.
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Correct Answer is D
Explanation
Choice A reason: While discussing the client's diagnosis with their family could be part of the care process, it does not address the client's immediate concern about the quality of care they are receiving. This response does not validate the client's feelings or provide an opportunity for them to elaborate on their concerns.
Choice B reason: Telling the client that their feelings are part of anticipatory grieving may be true, but it can come across as dismissive and does not offer support for the specific issue the client has raised about the quality of care.
Choice C reason: Assuring the client that the nurses are trying to provide good care does not acknowledge the client's perception of inadequate care. It's important to validate the client's feelings and understand their perspective before offering reassurances.
Choice D reason: Asking the client to elaborate on their concerns shows empathy and a willingness to listen. It allows the nurse to gather more information about the client's experience and identify specific areas that may need improvement in the care provided.
Correct Answer is C
Explanation
Choice A reason: Taking a 1-hour nap every day is not recommended for individuals with sleep disruptions, especially due to depressive disorder, as it can further disrupt nighttime sleep patterns.
Choice B reason: Exercising late in the day can be stimulating and may make it harder to fall asleep. It is generally advised to exercise earlier in the day to improve sleep quality.
Choice C reason: Keeping a sleep diary is a beneficial intervention for individuals with sleep disruptions. It can help identify patterns and behaviors that affect sleep and is a step towards establishing a consistent sleep schedule.
Choice D reason: Discontinuing medication without medical advice is not safe. Medications for depressive disorder should be managed by a healthcare provider, especially as abrupt changes can have serious consequences.
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