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?
Total bilirubin 1.5 mg/dL
Potassium 4.2 mEq/L
WBC count 5,000/mm³
Hct 44
The Correct Answer is A
A. The nurse should report the Total bilirubin 1.5 mg/dL to the provider.
Amitriptyline is an antidepressant medication, and elevated total bilirubin levels can indicate potential liver dysfunction or impairment. It's important to report any significant changes in liver function values to the provider, especially when a client is taking medications that can affect liver metabolism. The other laboratory values mentioned are within normal ranges and would not typically be of concern in the context of amitriptyline use.
B. Potassium 4.2 mEq/L:
This value is within the normal range. Potassium levels of 4.2 mEq/L are considered normal. While potassium levels are important to monitor, this result does not indicate a need for immediate reporting.
C. WBC count 5,000/mm³:
This value is within the normal range. A white blood cell (WBC) count of 5,000/mm³ is within the typical range. It suggests a normal immune response and does not require reporting.
D. Hct 44: This value is incorrect. The hematocrit (Hct) value of 44 is not accompanied by the unit of measurement (percentage or fraction). Hematocrit values measure the proportion of red blood cells in the blood and are usually reported as a percentage. If this value is indeed 44%, it falls within a normal range for both men and women. However, if the unit is different (such as a 44% fraction), it might be an incorrect unit conversion. The nurse should verify the unit of measurement and report any discrepancies or errors to the provider for clarification.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Estrogen-progestin combination:
Correct Answer: This medication interacts with carbamazepine.
Explanation: Carbamazepine is known to induce certain liver enzymes, including cytochrome P450 enzymes. These enzymes play a role in the metabolism of various medications, including estrogen-containing oral contraceptives (estrogen-progestin combinations). Carbamazepine can increase the metabolism of estrogen-progestin combinations, potentially reducing their effectiveness and increasing the risk of contraceptive failure. Therefore, this interaction can lead to decreased contraceptive efficacy and the potential for unintended pregnancy.
B. Nicotine transdermal system:
Incorrect Explanation: This medication does not interact with carbamazepine.
Explanation: Nicotine replacement therapies, such as nicotine transdermal systems, are not known to have significant interactions with carbamazepine. These therapies are primarily used to aid in smoking cessation and do not share metabolic pathways with carbamazepine.
C. Diphenhydramine:
Incorrect Explanation: This medication does not interact with carbamazepine.
Explanation: Diphenhydramine is an antihistamine used for allergies and as a sleep aid. It does not have a well-established interaction with carbamazepine. However, it's important to note that carbamazepine can have central nervous system (CNS) effects, so caution should be exercised when combining it with other medications that also have CNS effects.
D. Beclomethasone:
Incorrect Explanation: This medication does not interact with carbamazepine.
Explanation: Beclomethasone is a corticosteroid used to manage inflammation associated with conditions like asthma and allergic rhinitis. It is not known to interact with carbamazepine. These two medications have different mechanisms of action and do not share significant metabolic pathways.
Correct Answer is D
Explanation
A. Orthostatic hypotension refers to a drop in blood pressure upon standing up quickly. This is not a commonly associated adverse effect of pioglitazone.
B. Tinnitus refers to ringing in the ears and is not typically related to pioglitazone use.
C. Insomnia (difficulty sleeping) is not commonly reported as an adverse effect of pioglitazone.
D. Fluid retention
The nurse should plan to monitor the client for the adverse effects of fluid retention.
Pioglitazone is an oral antidiabetic medication that belongs to the thiazolidinedione class. One of the common adverse effects of pioglitazone is fluid retention or edema. This occurs due to its mechanism of action which can cause fluid buildup in the body's tissues, particularly in the lower extremities. Clients taking pioglitazone should be monitored for signs of edema, such as swelling in the ankles, legs, or feet. Monitoring for weight gain and any signs of worsening heart failure is also important.
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