A nurse is teaching a client who has active pulmonary tuberculosis about management of medication for the disease. Which of the following statements is appropriate for the nurse to make?

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.

A. Administer the medication into the client's muscles.
Explanation: This is incorrect because enoxaparin is usually administered subcutaneously, not into the muscle.
B. Apply firm pressure to the injection site following administration.
Explanation: This is incorrect because while applying gentle pressure after a subcutaneous injection is common practice, it is not specific to enoxaparin.
C. Insert the syringe needle halfway into the client's skin.
Explanation: This is incorrect because the needle should be inserted fully into the subcutaneous tissue, not just halfway, for proper administration of enoxaparin.
D. Expel the air bubble from the syringe prior to injection.
Explanation: This is the correct action. Expelling air bubbles from the syringe prior to injection helps ensure accurate dosing and prevents air from being injected into the subcutaneous tissue.
When administering enoxaparin (low molecular weight heparin) subcutaneously, it's important to expel any air bubbles from the syringe before injection. Air bubbles can cause discomfort and inaccuracies in dosage. The nurse should gently tap the syringe to move air bubbles to the top and then push the plunger slightly to expel the air. The other options are not correct procedures for administering enoxaparin. It is typically injected into the subcutaneous tissue, not a muscle, and firm pressure is not typically applied after administration. The needle is fully inserted into the skin, not halfway.