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 C
Explanation
Choice A Reason:
"I will have my partner tilt their head back while I am instilling the drops." Is incorrect. Tilting the head back is not typically recommended for administering optic medication as it might cause the medication to flow out instead of remaining in the ear canal.
Choice B Reason:
"I will make sure the solution is cool prior to instilling the drops." Is incorrect. The temperature of the solution usually doesn't need to be adjusted before instilling optic drops unless directed otherwise by specific medication instructions or healthcare provider guidance.
Choice C Reason:
"I will pull the pinna upward and outward prior to instilling the drops." Is correct statement. Pulling the pinna (outer ear) upward and outward helps straighten the ear canal in adults, facilitating the proper administration of optic (ear) drops. This action helps ensure that the medication reaches the ear canal effectively.
Choice D Reason:
"I will have my partner lie down on their back while I am instilling the drops." Is incorrect statement.
Having the partner lie down on their back might not be necessary for administering optic medication and might not be the optimal position for effective instillation.
Correct Answer is B
Explanation
Choice A Reason:
Dry cough is incorrect. While cough can be a side effect of amphotericin B, it's not a hallmark sign of an acute infusion reaction.
Choice B Reason:
Fever is correct. Acute infusion reactions to amphotericin B can manifest in various ways, and fever is a common sign indicating an immediate adverse reaction during the infusion. Other potential signs of an acute infusion reaction may include chills, rigors, hypotension, flushing, headache, or nausea.
Choice C Reason:
Pedal edema is incorrect. Swelling of the feet or pedal edema is not a typical manifestation of an acute infusion reaction to amphotericin B.
Choice D Reason:
Hyperglycemia is incorrect. Increased blood glucose levels (hyperglycemia) are not commonly associated with an acute infusion reaction to amphotericin B. However, amphotericin B may have effects on electrolytes and kidney function that could indirectly impact glucose levels.
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