An older adult client has been prescribed metformin for the treatment of type 2 diabetes for several years. Which change in the client's laboratory values may demonstrate a need to discontinue the medication?
An increase in serum lactate
A decrease in hemoglobin and hematocrit
An increase in white blood cells
A decrease in potassium accompanied by an increase in sodium
The Correct Answer is A
A. An increase in serum lactate – This is a critical laboratory value that can indicate lactic acidosis, a serious side effect associated with metformin, especially in older adults or those with renal impairment. An increase in serum lactate necessitates discontinuation of the medication.
B. A decrease in hemoglobin and hematocrit – While this change may indicate anemia, it is not directly associated with the need to discontinue metformin. Further evaluation of the cause of anemia would be necessary.
C. An increase in white blood cells – This could indicate an infection or inflammatory process but does not specifically necessitate the discontinuation of metformin.
D. A decrease in potassium accompanied by an increase in sodium – While electrolyte imbalances should be monitored, this change does not directly indicate that metformin should be discontinued.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Schizophrenia is believed to be related to an overactivity of the dopamine system in certain areas of the brain. Antipsychotic medications, which are the primary treatment for schizophrenia, work by blocking dopamine receptors, thereby decreasing the activity of the dopamine system. This is referred to as the dopamine hypothesis of schizophrenia.
Correct Answer is C
Explanation
Hydrocortisone is a glucocorticoid hormone that is usually prescribed for the treatment of Addison's disease, which is characterized by insufficient production of adrenal hormones. It is important to take hydrocortisone in the morning before 09:00 because this is when the body's natural cortisol levels are at their highest. Taking hydrocortisone at this time can help to mimic the body's natural cortisol production and prevent adrenal crisis. It should be taken with meals to reduce the risk of stomach upset.
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