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

Answer and Explanation

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.

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Correct Answer is C

Explanation

Dextroamphetamine is a central nervous system (CNS) stimulant that is used to treat ADHD and narcolepsy. The drug has a high potential for abuse and dependence, and therefore it carries a black box warning from the FDA. The black box warning is the strongest warning that the FDA requires, and it indicates that a drug has a significant risk of serious or life-threatening adverse effects.

The black box warning for dextroamphetamine relates to its potential for abuse, addiction, and misuse. The drug should only be used as directed by a healthcare provider, and clients should be advised not to share their medication with others or to take more than the prescribed dose. Excessive doses of dextroamphetamine can lead to serious adverse effects, including stroke and heart attack. Clients should also be advised to store their medication securely and to dispose of any unused medication properly.

A. Sodium B. Potassium C. Calcium D. Water

Correct Answer is A

Explanation

Hydrocortisone is a synthetic form of the hormone cortisol, which is produced by the adrenal glands. Addison's disease is a condition in which the adrenal glands do not produce enough cortisol and other hormones. Treatment with hydrocortisone is a lifelong therapy that replaces the missing hormones.

One of the potential adverse effects of long-term treatment with hydrocortisone is the development of sodium depletion or hyponatremia. This occurs because hydrocortisone can increase the excretion of sodium in the urine, leading to low levels of sodium in the blood.

To mitigate this potential adverse effect, the nurse should encourage the client to increase their intake of sodium. This can be done through dietary sources such as adding more salt to their food or drinking sports drinks that contain electrolytes. The client should also be monitored closely for signs of sodium depletion, such as weakness, fatigue, and confusion.

It is also important to note that long-term treatment with hydrocortisone can increase the risk of other adverse effects, such as osteoporosis, hyperglycemia, and infection. The nurse should educate the client on these potential adverse effects and encourage them to follow their healthcare provider's instructions for monitoring and management.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is being prescribed dextroamphetamine for the treatment of attention deficit hyperactivity disorder (ADHD). During health education, the nurse should make the client aware of the black box warning relating to what potential risk issue?

Correct Answer is C

Explanation

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Correct Answer is A

Explanation

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