To prevent deep vein thromboses following knee replacement surgery, an adult male client is receiving daily subcutaneous enoxaparin. Which laboratory result requires immediate action by the nurse?

Reference Range:
Hematocrit [42% to 52% (0.42 to 0.52 volume fraction)]
Platelets [150,000 to 400,000/mm² (150 to 400 × 10^9/L)]
Creatinine [0.5 to 1.1 mg/dL (44 to 97 μmol/L)]
Blood Urea Nitrogen (BUN) [10 to 20 mg/dL (3.6 to 7.1 mmol/L)]

Choice A reason: Increasing intake of fluids and high protein foods is not an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that relaxes skeletal muscles and reduces spasticity. Fluids and high protein foods do not affect the action or side effects of baclofen.

Choice B reason: Stopping taking the medication immediately is not an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that should be tapered off gradually under medical supervision. Abrupt withdrawal of baclofen can cause serious complications, such as seizures, hallucinations, and increased spasticity.

Choice C reason: Obtaining transportation to the emergency department is not an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that can cause mild and transient side effects, such as fatigue and dizziness. These side effects are not life-threatening and usually subside as the body adjusts to the medication.

Choice D reason: Avoiding hazardous activities until symptoms subside is an instruction that the nurse should provide to the client who is taking baclofen, which is a medication that can impair the ability to drive, operate machinery, or perform other tasks that require alertness and coordination. The client should be advised to exercise caution and avoid activities that could result in injury until they are no longer experiencing fatigue and dizziness.

Choice A reason: Using a Snellen chart to assess visual acuity is not a direct measure of the effectiveness of pilocarpine, which is used to lower intraocular pressure by constricting the pupil and increasing aqueous humor outflow. Visual acuity may be affected by other factors, such as refractive errors, cataracts, or macular degeneration.

Choice B reason: Checking the amount of drainage from each eye is not a relevant action for evaluating the effectiveness of pilocarpine, which does not affect tear production or drainage. Excessive or abnormal eye drainage may indicate an infection, allergy, or injury.

Choice C reason: Palpating the eyelids for decreased swelling is not a useful action for evaluating the effectiveness of pilocarpine, which does not cause or reduce eyelid swelling. Eyelid swelling may be caused by inflammation, infection, allergy, or trauma.

Choice D reason: Reviewing eye pressure measurements is the correct action for evaluating the effectiveness of pilocarpine, which is used to lower intraocular pressure in patients with open-angle glaucoma. High intraocular pressure can damage the optic nerve and cause vision loss. Pilocarpine reduces intraocular pressure by constricting the pupil and increasing aqueous humor outflow.