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 D
Explanation
Atomoxetine is a non-stimulant medication that is used to treat attentiondeficit/hyperactivity disorder (ADHD). Unlike central nervous system (CNS) stimulants such as dextroamphetamine, dexmethylphenidate, and dextroamphetamine/amphetamine, atomoxetine does not have a high risk of abuse or dependence.
CNS stimulants like dextroamphetamine, dexmethylphenidate, and dextroamphetamine/amphetamine can be effective in treating ADHD symptoms, but they can also be abused and lead to dependence. These medications work by increasing levels of dopamine and norepinephrine in the brain, which can improve focus and attention. However, they also have the potential to be misused, particularly by individuals seeking a "high" or increased alertness.
In contrast, atomoxetine works by selectively inhibiting the reuptake of norepinephrine in the brain. This mechanism of action does not produce the same effects on dopamine levels as CNS stimulants, and it is not associated with a high risk of abuse or dependence. However, it may take several weeks for the full therapeutic effects of atomoxetine to be seen, and it may not be as effective as CNS stimulants for some individuals with ADHD.
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.
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