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: Depression screening is not directly related to the effectiveness of orlistat, which is a medication that blocks the absorption of fat from the diet and helps to reduce weight. Depression screening may be important for the overall mental health of the client, but it is not an ongoing assessment for orlistat.

Choice B reason: Body mass index (BMI) is a measure of body fat based on height and weight, and it is used to assess the risk of obesity-related health problems. BMI is an ongoing assessment for orlistat, because it can indicate the progress and outcome of the weight management program. The goal of orlistat therapy is to achieve and maintain a healthy BMI.

Choice C reason: Daily calorie count is not an ongoing assessment for orlistat, because it does not reflect the amount of fat absorbed by the body. Orlistat works by blocking the action of lipase, an enzyme that breaks down fat in the intestine. Therefore, even if the client consumes a high-calorie diet, orlistat can prevent some of the fat from being absorbed and reduce weight. However, daily calorie count may be useful for monitoring the overall nutritional intake and energy balance of the client.

Choice D reason: Serum protein levels are not an ongoing assessment for orlistat, because they are not affected by the medication. Orlistat only blocks the absorption of fat, not protein or carbohydrates. Serum protein levels may be important for evaluating the nutritional status and organ function of the client, but they are not an indicator of orlistat effectiveness.

Choice A reason: Eliminating use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, is an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that stabilizes mood and prevents manic episodes. NSAIDs can increase the blood levels of lithium and cause toxicity, which can manifest as nausea, vomiting, tremors, confusion, or seizures.

Choice B reason: Monitoring blood glucose levels daily is not an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that does not affect the blood sugar levels or the risk of diabetes. Blood glucose levels may be important for the general health of the client, but they are not related to lithium therapy.

Choice C reason: Notifying healthcare provider prior to dental procedures is not an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that does not interact with local anesthetics or antibiotics that may be used during dental procedures. However, the client should inform the dentist about their medical history and medications, as a precaution.

Choice D reason: Avoiding consuming all foods that contain iodine is not an instruction that the nurse should provide to the client who is taking lithium carbonate, which is a medication that does not interfere with the thyroid function or the metabolism of iodine. Iodine is an essential nutrient that is found in many foods, such as seafood, dairy products, eggs, and iodized salt. Avoiding iodine can cause deficiency and lead to goiter or hypothyroidism.