An older female client comes to the clinic for a regular check-up. The client tells the nurse that she has increased her daily doses of acetaminophen for the past month to control joint pain. Based on this patient's comment, which previous laboratory results should the nurse compare with today's laboratory report?
Determine if there is a decrease in serum potassium due to renal compromise
Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding.
Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration.
Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage.
The Correct Answer is D
A. Determine if there is a decrease in serum potassium due to renal compromise: Acetaminophen is not commonly associated with significant renal impairment or changes in serum potassium levels, making this a less relevant consideration.
B. Expect to find an increase in today's activated partial thromboplastin time (APTT) as compared to last quarter's due to bleeding: Acetaminophen does not significantly affect APTT or bleeding risk, so changes in APTT would not be expected due to acetaminophen use.
C. Look at last quarter's hemoglobin and hematocrit, expecting an increase today due to dehydration: Acetaminophen is not known to cause changes in hemoglobin and hematocrit levels or dehydration-related increases in these values.
D. Look for an increase in today's lactic dehydrogenase (LDH) compared to the previous one to assess for possible liver damage: Acetaminophen overdose or chronic high use can lead to liver damage, which would be indicated by elevated LDH levels. Monitoring LDH is appropriate to assess for potential liver damage related to acetaminophen use.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Protect the skin from sunlight while taking the drug: Tetracycline is known to increase sensitivity to sunlight, leading to a higher risk of sunburn and skin reactions. Advising clients to protect their skin from sun exposure and to use sunscreen is essential to prevent these adverse effects. This precaution helps mitigate the risk of photosensitivity reactions that are commonly associated with tetracycline use.
B) Take with orange juice to enhance gastrointestinal (GI) absorption: Tetracycline should not be taken with dairy products or antacids, as they can bind with the medication and reduce its absorption. While orange juice can enhance absorption, this is not a standard recommendation for tetracycline. Instead, it is generally advised to take tetracycline with water and avoid substances that could interfere with its absorption.
C) Return to the clinic weekly to obtain serum drug levels: Tetracycline typically does not require regular monitoring of serum drug levels, as it does not have a narrow therapeutic index like some other drugs. Instead, patients are generally advised on how to manage side effects and adherence to the medication regimen, rather than frequent clinic visits for drug level monitoring.
D) Take with milk or antacids to prevent gastrointestinal (GI) irritation: Milk and antacids should be avoided when taking tetracycline because they can bind to the medication and significantly reduce its effectiveness. This instruction could lead to decreased therapeutic efficacy and should be avoided. Tetracycline should be taken on an empty stomach to ensure optimal absorption, avoiding interactions with these substances.
Correct Answer is D
Explanation
A. Fingerstick glucose: While important in managing diabetes or hypoglycemia, it is not directly related to evaluating the effectiveness of lactulose in treating hepatic encephalopathy.
B. Stool color and character: Lactulose acts as a laxative, and its effectiveness can affect stool characteristics. However, stool color and character are less direct indicators of therapeutic response compared to serum ammonia levels.
C. Serum hepatic enzymes: While liver enzyme levels can provide information about liver function, they do not directly measure the effectiveness of lactulose in managing hepatic encephalopathy. Serum ammonia levels are more specific for this purpose.
D. Serum electrolytes and ammonia: Lactulose is used to treat hepatic encephalopathy by reducing blood ammonia levels. Monitoring serum ammonia levels provides direct feedback on the effectiveness of the medication in treating hepatic encephalopathy. Additionally, serum electrolytes should be monitored because lactulose can lead to electrolyte imbalances due to its laxative effect.
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