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?
WBC count 5,000/mm.
Total bilirubin 1.5 mg/dL.
Hct 44%.
Potassium 5.2 mEq/L.
The Correct Answer is D
A WBC count of 5,000/mm3 is low and could indicate leukopenia, a possible side effect of amitriptyline. Leukopenia increases the risk of infection and should be reported to the provider.
Choice B is wrong because a total bilirubin of 1.5 mg/dL is within the normal range of 0.3 to 1.9 mg/dL.
Choice C is wrong because a Hct of 44% is within the normal range of 37% to 48% for women and 45% to 52% for men.
Choice D is wrong because a potassium level of 4.2 mEq/L is within the normal range of 3.5 to 5.0 mEq/L.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
This is a high level of potassium in the blood (the normal range is 3.5 to 5 mEq/L) and can be dangerous for the heart.
Triamterene is a potassium-sparing diuretic that prevents the body from losing too much potassium in the urine. It can cause hyperkalemia (high potassium), especially in people with kidney disease, diabetes, or severe illness. The nurse should check the potassium level before giving triamterene and hold the medication if it is above 5 mEq/L.
The other choices are incorrect because:
Choice A: Sodium 142 mEq/L.
This is a normal level of sodium in the blood (the normal range is 135 to 145 mEq/L) and does not require withholding triamterene. Triamterene can cause hyponatremia (low sodium) by increasing the excretion of sodium in the urine. The nurse should monitor the sodium level during triamterene therapy and report any signs of low sodium such as confusion, weakness, or seizures.
Choice B: BUN 16 mg/dL.
This is a normal level of blood urea nitrogen (BUN) in the blood (normal range is 7 to 20 mg/dL) and does not require withholding
triamterene. BUN is a measure of kidney function and can be elevated in kidney disease or dehydration. Triamterene can cause an increase in BUN by reducing the blood flow to the kidneys or by interacting with other medications that affect the kidneys. The nurse should monitor the BUN level during triamterene therapy and report any signs of kidney impairment such as decreased urine output, swelling, or nausea. •
Choice D: Albumin 4 g/dL.
This is a normal level of albumin in the blood (the normal range is 3.4 to 5.4 g/dL) and does not require withholding triamterene. Albumin is a protein that helps maintain fluid balance and transport substances in the blood. Triamterene does not affect albumin levels directly, but it can cause fluid loss or retention that may alter albumin levels indirectly. The nurse should monitor the albumin level during triamterene therapy and report any signs of fluid imbalance such as weight changes, edema, or shortness of breath.
Correct Answer is C
Explanation
The nurse who caused the error is responsible for completing an incident report. An incident report is a tool for documenting any event that deviates from the standard of care or causes harm to a client, staff member, or visitor. The purpose of an incident report is to improve quality and safety, not to assign blame or punish anyone. The nurse who caused the error should fill out the report as soon as possible after the event, providing factual and objective information.
Choice A is wrong because the quality improvement committee is not directly involved in the incident and does not complete the report.
The committee may review the report later to identify trends and areas for improvement.
Choice B is wrong because the charge nurse is not responsible for completing the report, although they may assist or supervise the nurse who caused the error.
The charge nurse may also notify the provider and other relevant staff members about the incident.
Choice D is wrong because the nurse who identifies the error is not responsible for completing the report, although they should notify the nurse who caused the error and help them correct it if possible.
The nurse who identifies the error may also provide additional information or witness statements for the report if needed.
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