The practical nurse (PN) is making a home visit to an older male adult who was recently diagnosed with Herpes zoster (shingles). The client reports the onset of severe burning pain along the right side of his trunk.

What action should the PN take?

The correct answer is choice B, Serum creatinine. Choice A rationale:

The white blood cell count (WBC) is an important parameter for assessing the body's immune response to infections. While it can provide valuable information about the presence of an infection, it is not directly related to nephrotoxicity. Therefore, it is not the most important laboratory value to review before administering an antibiotic that can cause nephrotoxicity.

Choice B rationale:

Serum creatinine is a crucial laboratory value to assess kidney function. It is a waste product that is filtered by the kidneys, and its level in the blood is a reliable indicator of kidney function. If the serum creatinine level is elevated, it suggests impaired kidney function, which can be a warning sign of nephrotoxicity. Reviewing the serum creatinine level before administering nephrotoxic antibiotics is essential to ensure that the client's kidneys are functioning adequately and to avoid potential harm.

Choice C rationale:

Hemoglobin and hematocrit are indicators of the client's red blood cell count and blood's oxygen-carrying capacity. While these values can provide information about the client's overall health status, they are not directly related to nephrotoxicity. Therefore, they are not the most important laboratory values to review in this particular scenario.

Choice D rationale:

Serum calcium levels are essential for assessing bone health, nerve function, and muscle contractions. However, they are not directly related to nephrotoxicity, and reviewing serum calcium levels alone would not provide sufficient information about kidney function. Hence, it is not the most critical value to review before administering nephrotoxic antibiotics

The correct answer is B. Extend the leg and flex the foot.

Choice A rationale:

Massaging the calf and foot is not recommended as it could potentially dislodge a blood clot if one is present, which can be dangerous.

Choice B rationale:

Extending the leg and flexing the foot helps to relieve the cramp by stretching the muscles involved. This is a safe and effective method to alleviate muscle cramps.

Choice C rationale:

Checking the pedal pulse in the affected leg is important for assessing circulation but does not directly address the immediate discomfort of the cramp.

Choice D rationale:

Elevating the leg above the heart is generally used to reduce swelling and improve circulation but is not specifically effective for relieving muscle cramps.

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