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 C
Explanation
A. Taking an antiemetic medication: This information is not directly relevant before administering misoprostol. Misoprostol does not typically interact with antiemetic medications in a way that would change the administration plan.
B. Allergy to aspirin: While important to know for general medication safety, misoprostol's primary concern is its potential effects on pregnancy rather than an allergy to aspirin.
C. Currently pregnant: Misoprostol is contraindicated in pregnancy due to its potential to induce uterine contractions and cause miscarriage. It is crucial to confirm that the patient is not pregnant before administering this medication.
D. History of glaucoma: While important for other medications, a history of glaucoma is not a primary concern when administering misoprostol.
Correct Answer is A
Explanation
A. Serum creatinine level of 1.6 mg/dL (141 µmol/L), a blood urea nitrogen (BUN) of 20 mg/dL (7.1 mmol/L): Gentamicin is an aminoglycoside that is known for its nephrotoxic potential. Elevated serum creatinine and BUN levels are indicative of impaired kidney function, which warrants further investigation and possible intervention. This finding is significant because it may reflect kidney damage or reduced renal clearance of the drug.
B. Reports a sore mouth and three episodes of diarrhea that began this morning: While these symptoms are important and could suggest a possible adverse effect or secondary infection, they are not as immediately concerning in the context of gentamicin therapy as the potential for kidney damage indicated by elevated creatinine and BUN levels.
C. White blood count of 9,000/mm³ (9 x 10^9/L) and an oral temperature of 98.2°F (36.7°C) two hours ago: These values are within normal ranges and do not suggest an immediate concern related to gentamicin toxicity.
D. Urinary output of 400 mL of clear, amber-colored urine in the past eight hours: While monitoring urinary output is important, this level of output does not necessarily indicate a problem in the context of gentamicin therapy compared to elevated creatinine and BUN levels.
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