The nurse is caring for a client who is taking diclofenac, a nonsteroidal anti-inflammatory (NSAID) drug for rheumatoid arthritis. During a clinic visit, the client appears pale and reports increasing fatigue. Which of the client's serum laboratory values is most important for the nurse to review?
Glucose.
Total protein.
Sodium.
Hemoglobin.
The Correct Answer is D
Choice A reason: This is not the most important laboratory value for the nurse to review. Glucose is a measure of blood sugar levels, and it may be affected by various factors, such as diet, medication, stress, or infection. However, glucose is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the glucose levels for any changes, but it is not the priority.
Choice B reason: This is not the most important laboratory value for the nurse to review. Total protein is a measure of the amount of protein in the blood, and it may reflect the nutritional status, liver function, or kidney function of the client. However, total protein is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the total protein levels for any changes, but it is not the priority.
Choice C reason: This is not the most important laboratory value for the nurse to review. Sodium is a measure of the electrolyte balance in the blood, and it may be affected by fluid intake, fluid loss, or hormonal regulation. However, sodium is not directly related to the use of diclofenac or the symptoms of the client. The nurse should monitor the sodium levels for any changes, but it is not the priority.
Choice D reason: This is the most important laboratory value for the nurse to review. Hemoglobin is a measure of the oxygen-carrying capacity of the blood, and it may indicate the presence of anemia, which is a common adverse effect of diclofenac. Diclofenac can cause gastrointestinal bleeding, which can lead to a decrease in hemoglobin and hematocrit levels. The client's appearance and fatigue may be signs of anemia, which can impair the tissue oxygenation and worsen the client's condition. The nurse should review the hemoglobin levels and report any abnormal findings to the healthcare provider. The nurse should also assess the client for other signs of bleeding, such as melena, hematemesis, or hematuria.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Lorazepam is a benzodiazepine that is used to treat anxiety, insomnia, and seizures. It is metabolized by the liver and does not have a significant effect on the kidneys. The nurse should monitor the client for signs of sedation, respiratory depression, and dependence.
Choice B reason: Digoxin is a cardiac glycoside that is used to treat heart failure and arrhythmias. It is eliminated by the kidneys and can cause toxicity if the renal function is impaired. The nurse should monitor the client's serum digoxin level, heart rate, and rhythm, and signs of toxicity, such as nausea, vomiting, visual disturbances, and confusion.
Choice C reason: Sucralfate is a mucosal protectant that is used to treat peptic ulcer disease. It forms a protective barrier over the ulcer and does not get absorbed into the bloodstream. It does not affect the kidneys and has few side effects. The nurse should monitor the client's symptoms and advise them to take the medication on an empty stomach.
Choice D reason: Vancomycin is an antibiotic that is used to treat serious infections caused by gram-positive bacteria. It is nephrotoxic and can cause AKI, especially in high doses or prolonged use. The nurse should monitor the client's serum vancomycin level, renal function tests, urine output, and signs of AKI, such as oliguria, edema, and electrolyte imbalances.
Correct Answer is A
Explanation
Choice A reason: This is the correct manifestation for the nurse to identify as a reason to stop the infusion. A scratchy throat may indicate an allergic reaction to piperacillin-tazobactam, which is a penicillin derivative. The client may also develop other signs of anaphylaxis, such as rash, itching, swelling, wheezing, or difficulty breathing. The nurse should stop the infusion immediately and notify the healthcare provider.
Choice B reason: This is not a correct manifestation for the nurse to identify as a reason to stop the infusion. Pupillary constriction is not a common or serious side effect of piperacillin-tazobactam. It may be caused by other factors, such as light exposure, medication use, or neurological conditions. The nurse should monitor the client's pupils for any changes, but it is not a reason to stop the infusion.
Choice C reason: This is not a correct manifestation for the nurse to identify as a reason to stop the infusion. Bradycardia, or a slow heart rate, is not a common or serious side effect of piperacillin-tazobactam. It may be caused by other factors, such as cardiac disorders, medication use, or vagal stimulation. The nurse should monitor the client's vital signs for any changes, but it is not a reason to stop the infusion.
Choice D reason: This is not a correct manifestation for the nurse to identify as a reason to stop the infusion. Hypertension, or high blood pressure, is not a common or serious side effect of piperacillin-tazobactam. It may be caused by other factors, such as stress, pain, or renal disorders. The nurse should monitor the client's blood pressure for any changes, but it is not a reason to stop the infusion.
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