A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?
Ondansetron
Acetaminophen
Nalbuphine
Insulin glargine
The Correct Answer is C
Choice A Reason:
Ondansetron is incorrect. Ondansetron is an anti-nausea medication commonly used in cancer patients to manage nausea and vomiting, often caused by chemotherapy. It's not typically contraindicated or known to interact significantly with morphine administered via a PCA pump. This combination is often used to manage both pain and associated symptoms in cancer patients.
Choice B Reason:
Acetaminophen is incorrect. Acetaminophen is a pain reliever and fever reducer that doesn't typically interact significantly with morphine administered via a PCA pump. It's often used concurrently with other pain medications to manage discomfort in cancer patients. There isn't a known significant interaction between acetaminophen and morphine when used appropriately.
Choice C Reason:
Nalbuphine is correct. Nalbuphine is an opioid analgesic, similar to morphine, and administering it concurrently with morphine could potentially lead to opioid overdose or increased risk of opioid-related side effects such as respiratory depression. Thus, it's crucial to clarify with the provider whether there might be a potential interaction or if both medications are indeed necessary in this specific clinical scenario.
Choice D Reason:
Insulin glargine is incorrect. Insulin glargine is a long-acting insulin used to manage blood sugar levels in individuals with diabetes. While its interaction with morphine isn't typically a concern, it's essential to monitor blood sugar levels closely in individuals receiving opioids like morphine, as opioids can affect glucose metabolism and may necessitate adjustments in insulin dosage.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
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.
Correct Answer is B
Explanation
Choice A Reason:
BUN 15 mg/dL (blood urea nitrogen) is incorrect. An elevated BUN level can indicate kidney dysfunction or dehydration, but it's not typically associated with azathioprine's adverse effects. Azathioprine is known to affect bone marrow, leading to decreased blood cell counts, rather than directly impacting kidney function.
Choice B Reason:
WBC 3,000/mm³ (low white blood cell count) is correct. Azathioprine is an immunosuppressive medication used to treat various conditions, including rheumatoid arthritis. One of its known adverse effects is bone marrow suppression, which can lead to decreased production of blood cells, including white blood cells (WBCs). A low WBC count (leukopenia) can increase the risk of infections due to compromised immune function, making it an important adverse effect to monitor in individuals taking azathioprine.
Choice C Reason:
Hct 45% (hematocrit) is incorrect. A hematocrit of 45% is within the normal range for both men and women. Azathioprine adverse effects usually manifest as blood cell-related issues (such as leukopenia) rather than directly impacting hematocrit levels.
Choice D Reason:
Platelets 250,000/mm³: Platelets within the range of 150,000 to 400,000/mm³ are considered normal. Azathioprine typically affects white blood cells more prominently than platelet counts.
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