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

Metformin is an oral medication used to lower blood sugar levels in clients with type 2 diabetes. It works by decreasing the production and absorption of glucose in the liver and intestines, respectively. However, metformin is contraindicated in clients with severe infections, as the drug can increase the risk of developing lactic acidosis, a rare but serious complication characterized by the buildup of lactic acid in the bloodstream.

During a severe infection, the body may experience a state of inflammation and stress, which can cause metabolic changes that increase the risk of developing lactic acidosis. Therefore, metformin should be temporarily discontinued in clients with severe infections and resumed only after the infection has been successfully treated and resolved.

In the meantime, the client's diabetic regimen may need to be adjusted to maintain appropriate blood sugar levels. This may include the use of alternative medications such as insulin, which can be used to control blood sugar levels during times of illness or infection. The healthcare provider will determine the appropriate management plan based on the individual client's needs and medical history.

A. Allows the accumulation of acetaldehyde B. Decreases stimulation of the central nervous system (CNS) C. Increases the level of acetylcholine d Increases the level of serotonin

Correct Answer is A

Explanation

Disulfiram is a medication used to treat alcohol use disorder (AUD). It works by inhibiting the enzyme acetaldehyde dehydrogenase, which is responsible for breaking down acetaldehyde, a toxic metabolite of alcohol. When alcohol is consumed while taking disulfiram, the accumulation of acetaldehyde in the body leads to unpleasant symptoms such as flushing, sweating, nausea, and vomiting. This creates an aversive reaction to alcohol consumption, which can help the client refrain from drinking.

The aversive effects of disulfiram can last for several hours to several days after alcohol consumption, depending on the dose of disulfiram and the amount of alcohol consumed. Therefore, it is important for clients taking disulfiram to avoid all sources of alcohol, including alcoholic beverages, mouthwash, and other products containing alcohol.

It is important to note that disulfiram is not a cure for AUD, and it works best when used as part of a comprehensive treatment plan that includes counseling and support. Disulfiram should only be used under the close supervision of a healthcare provider, as it can have serious side effects if used improperly.

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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 who regularly takes metformin has developed a severe infection. How will the infection change the established diabetic regimen?

Correct Answer is C

Explanation

A client is prescribed disulfiram. How does this medication assist the client in refraining from ingestion of alcohol?

Correct Answer is A

Explanation

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