The nurse is reviewing the laboratory findings for a 34-year-old woman who is scheduled for a Schilling's test for B12 deficiency anemia. Which result should the nurse report immediately to the primary care provider?

Choice a reason:
Warming the hands with water before testing is actually a recommended practice. It helps increase blood flow to the fingertips, making it easier to get a sufficient blood sample for testing. Cold hands can restrict blood flow, leading to difficulty in obtaining a blood sample and potentially inaccurate results.

Choice b reason:
Alternating fingers for blood glucose testing is also a recommended practice. It helps prevent soreness and calluses on the fingers from repeated pricks. Using different fingers or different sides of the same finger can help reduce pain and potential damage to the skin.

Choice c reason:
Choosing the center of the finger pad as a puncture site is not recommended. The sides of the fingertips are preferred because they have fewer nerve endings, making the process less painful. The center of the finger pad has a denser nerve supply and can lead to more discomfort during the test.

Choice d reason:
A random blood glucose result of 115 mg/dL is slightly above the normal range for non-diabetics, which is typically between 70 to 99 mg/dL when fasting. For someone with diabetes, this result might be considered within a target range, depending on individual treatment goals set by healthcare providers. However, it's important to note that a single glucose reading does not provide a complete picture of glucose control. An A1C test, which reflects average blood glucose levels over the past 2-3 months, is also necessary to assess overall glucose management.

Choice a reason:
Including yogurt in the diet can be beneficial for a client experiencing diarrhea related to antibiotic therapy. Yogurt contains probiotics, which are live microorganisms that can provide health benefits when consumed. These probiotics can help restore the balance of good bacteria in the gut that antibiotics may have disrupted, potentially reducing the duration and severity of diarrhea. However, it's important to choose yogurts that contain active probiotics and to be aware that some individuals may not tolerate dairy well during a bout of diarrhea.

Choice b reason:
Administering famotidine 20 mg daily may help with symptoms of gastritis or peptic ulcers but is not directly related to treating antibiotic-associated diarrhea. Famotidine is a histamine-2 blocker used to reduce stomach acid and is not typically used as a treatment for diarrhea. It should be noted that if a patient is experiencing severe diarrhea, the underlying cause should be addressed rather than just managing symptoms.

Choice c reason:
Testing stool for occult blood is generally not a standard intervention for antibiotic-related diarrhea unless there is a suspicion of gastrointestinal bleeding or an infection like C. difficile, which can cause more severe colitis. Occult blood tests are more commonly used for screening for colorectal cancer or diagnosing conditions that cause gastrointestinal bleeding.

Choice d reason:
Arranging for IV administration of the antibiotic instead of the oral route may be considered if the client has severe diarrhea that prevents the absorption of oral medications or if the client is unable to tolerate oral intake[^10^]¹¹¹²¹³¹⁴. However, many antibiotics have excellent oral bioavailability, and switching from IV to oral antibiotics when appropriate can be just as effective and is often preferred due to convenience and lower risk of complications.