A nurse is reviewing the laboratory results of a client who is taking amitriptyline. Which of the following laboratory values should the nurse report to the provider?
Hct 44%
WBC count 5,000/mm3
Potassium 4.2 mEq/L
Total bilirubin 1.5 mg/dL
The Correct Answer is D
Choice A Reason:
Hct 44% is incorrect. A hematocrit (Hct) level of 44% falls within the normal range for most adults. It represents the proportion of red blood cells in the blood and is not typically concerning unless it significantly deviates from the normal range, indicating anemia or polycythemia.
Choice B Reason:
WBC count 5,000/mm3 is incorrect. A white blood cell (WBC) count of 5,000/mm3 falls within the normal range for adults, reflecting a normal immune response. There's usually no cause for immediate concern unless there are specific clinical symptoms or significant deviations from the normal range.
Choice C Reason:
Potassium 4.2 mEq/L is incorrect. A potassium level of 4.2 mEq/L is within the normal range for serum potassium levels. It's crucial to monitor potassium levels, especially with medications that can affect electrolyte balance, but this value falls within the typical range and may not prompt immediate action unless there are notable fluctuations or clinical symptoms related to potassium imbalance.
While the majority of the laboratory values provided fall within the normal range, the value that the nurse should consider reporting to the provider, particularly when a client is taking amitriptyline, is:
Choice D Reason:
Total bilirubin 1.5 mg/dL is correct. Elevated levels of total bilirubin might indicate potential liver function impairment. Amitriptyline, an antidepressant, can affect liver enzymes in some individuals, causing hepatic changes. Therefore, it's crucial to monitor liver function tests, including total bilirubin, during amitriptyline therapy. An increase in bilirubin levels could signal hepatotoxicity or liver dysfunction related to the medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A Reason:
"You should monitor for hearing difficulties." is correct. Loop diuretics like bumetanide can occasionally cause ototoxicity, resulting in hearing difficulties or ringing in the ears (tinnitus) as a potential adverse effect. It's important for clients taking these medications to be aware of such symptoms and report them promptly to their healthcare provider.
Choice B Reason:
"You should take the medication at bedtime." Is incorrect. Bumetanide is commonly prescribed to be taken in the morning to avoid nighttime diuresis and potential sleep disruption due to increased urination.
Choice C Reason:
"You should decrease your intake of foods high in potassium." Is incorrect. Loop diuretics often lead to potassium loss, so clients may actually need to increase their intake of potassium-rich foods or take potassium supplements under healthcare provider guidance to maintain normal potassium levels.
Choice D Reason:
"You should take this medication on an empty stomach." Is incorrect. Bumetanide can be taken with or without food, so it's not necessary to take it on an empty stomach.
Correct Answer is C
Explanation
Choice A Reason:
"I should avoid drinking grapefruit juice." This statement is actually accurate. Grapefruit juice can interfere with the metabolism of certain statin medications, including lovastatin, leading to increased levels of the drug in the body. Advising against grapefruit juice consumption is a recommended precaution when taking lovastatin, so this statement shows the client's understanding of this interaction.
Choice B Reason:
"I am trying to decrease my dietary fat intake." This statement reflects a positive lifestyle change. Lowering dietary fat intake is often recommended for individuals on statin medications to help manage cholesterol levels. This statement demonstrates the client's commitment to making healthy dietary adjustments, which aligns with the treatment plan.
Choice B Reason:
"I was just diagnosed with hepatitis B. "Hepatitis B can affect liver function, and statin medications like lovastatin can potentially impact liver enzymes. Therefore, in someone with a history of hepatitis B, it's crucial to assess liver function before starting a statin and to monitor the liver during treatment. This statement raises concerns about potential liver complications or interactions that require further evaluation before initiating lovastatin.
Choice D Reason:
"I take metformin for my diabetes." Metformin, a medication for diabetes, does not directly interact with lovastatin. While it's relevant to know the client's other medications, this statement doesn't indicate a need for immediate further assessment regarding the use of lovastatin.
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