A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen.
Which of the following findings should the nurse identify as a contraindication for receiving this medication?

Colesevelam is a bile acid sequestrant that lowers cholesterol by binding to bile acids in the intestine and preventing their reabsorption into the bloodstream. Some possible explanations for the other choices are:

Choice A. Chlorpromazine is wrong because it is an antipsychotic medication that has no effect on cholesterol levels.

Choice C. Colchicine is wrong because it is an anti-inflammatory drug that is used to treat gout and other inflammatory conditions, not high cholesterol.

Choice D. Cimetidine is wrong because it is a histamine H2 receptor antagonist that reduces stomach acid production and is used to treat ulcers and gastroesophageal reflux disease (GERD), not high cholesterol.

Normal ranges for cholesterol levels vary depending on the type of cholesterol and the risk factors of the individual, but generally, total cholesterol should be less than 200 mg/dL, LDL cholesterol should be less than 100 mg/dL, HDL cholesterol should be more than 40 mg/dL for men and 50 mg/dL for women, and triglycerides should be less than 150 mg/dL.

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.