The nurse is providing medications to an adult patient with a history of advanced kidney disease. Which laboratory finding indicates that the dosages of medications may need to be decreased?

Hemoglobin 12 mg/dL

Glucose 100 mg/dL

Creatinine 8 mg/dL

Potassium 4.0 mEq/L

Answer and Explanation

The Correct Answer is C

A. Hemoglobin 12 mg/dL: Hemoglobin levels reflect the oxygen-carrying capacity of the blood and are not directly related to kidney function or medication dosage adjustments. This value is within the normal range and does not suggest a need for medication dosage changes.

B. Glucose 100 mg/dL: Blood glucose levels are not directly related to kidney function and do not indicate the need to adjust medication dosages. This value is within normal limits.

C. Creatinine 8 mg/dL: Creatinine levels are a key indicator of kidney function. A creatinine level of 8 mg/dL is significantly elevated, suggesting severe renal impairment. Medications that are excreted by the kidneys may need to be dosed lower or avoided altogether to prevent toxicity.

D. Potassium 4.0 mEq/L: This is a normal potassium level and does not indicate the need for medication dosage adjustments. While potassium levels are important in kidney disease, this specific value does not suggest a dosage change is necessary.

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Correct Answer is A

Explanation

A. Replacement: Hypothyroidism is typically treated with hormone replacement therapy, such as levothyroxine, to compensate for the deficient thyroid hormone.

B. Curative: There is no cure for hypothyroidism, so curative therapy is not applicable. Treatment focuses on managing symptoms through hormone replacement.

C. Prophylactic: Prophylactic medications are used to prevent disease or conditions. This is not applicable to the treatment of hypothyroidism.

D. Palliative: Palliative care focuses on relieving symptoms in serious illness without curing the disease. However, hypothyroidism is managed with replacement therapy, not palliative care.

A. Notify the charge nurse that patients may have received inappropriate medication dosages. B. Evaluate the laboratory values of each patient to determine liver and kidney function as a possible reason for decreased dosages C. Do not worry about the discrepancy because this is not the nurse's unit. D. Call the nursing supervisor to investigate the nurse's concerns.

Correct Answer is B

Explanation

A. Notify the charge nurse that patients may have received inappropriate medication dosages.
Jumping to conclusions about inappropriate dosages without first investigating the rationale for the dosing is premature and could cause unnecessary alarm.

B. Evaluate the laboratory values of each patient to determine liver and kidney function as a possible reason for decreased dosages. Lower dosages are often prescribed for older adults due to decreased liver and kidney function, which can affect drug metabolism and excretion. Evaluating lab values ensures that these dosages are appropriate and safe.

C. Do not worry about the discrepancy because this is not the nurse's unit.
Ignoring the discrepancy is not appropriate, as it’s important for all nurses to advocate for patient safety, regardless of the unit.

D. Call the nursing supervisor to investigate the nurse's concerns.
The nursing supervisor may need to be involved, but the first step is to review the relevant clinical data (lab values) to assess the situation.

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The nurse is providing medications to an adult patient with a history of advanced kidney disease. Which laboratory finding indicates that the dosages of medications may need to be decreased?

Nursing Test Bank

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