A nurse is reviewing the medical record of a client who has beers taking a medication that can cause hepatoxicity. Which of the following data should the nurse report to the provider?

HbA1C 5.9%

Albumin 3.8 g/dl

Alanine aminotransferase (ALT) 67 units/l

Aspartate aminotransferase (AST) 39 units/l

Answer and Explanation

The Correct Answer is C

Here is the rationale for each choice:

A. HbA1C 5.9%: HbA1C is a measure of long-term glucose control in patients, often used in diabetes management. A value of 5.9% is slightly above the normal range (4–5.7%) but does not indicate hepatotoxicity.

B. Albumin 3.8 g/dl: Albumin is a protein produced by the liver, and its levels can reflect liver function. A normal range is 3.5–5 g/dl, and 3.8 g/dl falls within this range. Thus, it does not indicate hepatotoxicity.

C. Alanine aminotransferase (ALT) 67 units/l: ALT is an enzyme primarily found in the liver and is a key marker for liver injury. The normal range for ALT is approximately 7–56 units/l. A value of 67 units/l is slightly elevated, which may suggest mild liver damage or hepatotoxicity. This result should be reported to the provider, as it could be associated with the medication’s impact on the liver.

D. Aspartate aminotransferase (AST) 39 units/l: AST is another enzyme used to evaluate liver function, though it is less specific to the liver than ALT, as AST is also found in other tissues such as the heart and muscles. The normal range for AST is roughly 10–40 units/l.

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Correct Answer is A

Explanation

A. Place the patient on a cardiac monitor and check the patency of the IV: Hypokalemia (K+ = 2.5 mEq/L) can cause life-threatening cardiac dysrhythmias, so cardiac monitoring is essential. Additionally, potassium is highly irritating to veins, so IV patency must be confirmed to prevent extravasation and tissue damage.

B. Administer potassium intravenously in an IV push bolus- NEVER give potassium IV push as it can cause fatal cardiac arrest. Potassium must always be diluted and infused slowly.

C. Discontinue other medications that may affect potassium levels- Adjusting medications may be necessary, but not an immediate priority over cardiac monitoring.

D. Avoid potassium-rich foods in the diet - Incorrect because the client needs potassium replacement, not restriction.

A. Distribution B. Excretion C. Metabolism D. Absorption

Correct Answer is A

Explanation

A. Distribution: Distribution refers to the movement of the drug from the bloodstream to tissues and organs. Poor circulation can impair drug distribution, leading to reduced effectiveness or toxic accumulation.

B. Excretion: Excretion is the elimination of drugs, primarily through the kidneys. While circulation plays a role, excretion is more directly affected by renal function.

C. Metabolism: Metabolism occurs primarily in the liver and is not the primary concern in a client with poor circulation.

D. Absorption: Absorption refers to how the drug enters the bloodstream, which is more dependent on the GI tract (oral meds) or injection site (IV, IM meds) rather than circulation.

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A nurse is reviewing the medical record of a client who has beers taking a medication that can cause hepatoxicity. Which of the following data should the nurse report to the provider?

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