Which client's laboratory value should the nurse review prior to administering the initial dose of a statin medication?
Serum liver enzymes.
Serum electrolytes.
Complete blood count.
Capillary blood glucose.
The Correct Answer is A
A. Serum liver enzymes: Statins are metabolized in the liver and can cause hepatotoxicity. Baseline liver enzyme levels, such as ALT and AST, should be reviewed before starting statin therapy to ensure the liver is functioning properly and to monitor for potential adverse effects.
B. Serum electrolytes: Electrolytes are important for overall health, but they are not specifically impacted by statin therapy. Reviewing electrolyte levels is not a priority before initiating statins unless other conditions warrant it.
C. Complete blood count: A complete blood count (CBC) provides valuable information about infection or anemia, but it is not directly related to the safety or monitoring of statin medications.
D. Capillary blood glucose: Statins have been associated with a slight risk of elevated blood glucose over long-term use, but an initial capillary blood glucose reading is not required prior to starting therapy. Liver function assessment is the priority.
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Related Questions
Correct Answer is ["B","C","D","F"]
Explanation
A. Ibuprofen: While ibuprofen can affect renal function and has its own risks in diabetes, it does not have a significant or consistent effect on insulin requirements. It is not a primary medication impacting glucose metabolism.
B. Oral contraceptive: Estrogen in oral contraceptives can cause increased insulin resistance, potentially requiring higher doses of insulin to maintain glucose control. Therefore, it can affect the client’s insulin needs.
C. Corticosteroids: Corticosteroids such as prednisone raise blood glucose levels by promoting gluconeogenesis and insulin resistance. Clients taking corticosteroids often require increased insulin dosing.
D. Epinephrine: Epinephrine stimulates glycogen breakdown and raises blood glucose levels as part of the stress response. It can significantly impact blood sugar control and thus influence insulin requirements.
E. St. John's Wort: St. John's Wort can interact with many medications, but its effect on insulin or blood glucose regulation is not strong enough to significantly alter insulin needs. It is more notable for affecting medications through liver enzyme induction.
F. Fluconazole: Fluconazole can inhibit the metabolism of some drugs and may increase insulin sensitivity in certain cases. It can alter glucose control by enhancing insulin action, which may lead to a need for insulin dose adjustments.
Correct Answer is A
Explanation
A. Hemoglobin level increased to 12 g/dL (7.45 mmol/L): Epoetin alfa stimulates red blood cell production, and an increase in hemoglobin is the primary indicator of the drug’s effectiveness. A hemoglobin of 12 g/dL reflects a significant therapeutic improvement in anemia management for a client with CKD.
B. Reports of increased energy levels and decreased fatigue: Although feeling more energetic is a positive clinical sign, it is subjective and does not provide objective evidence of improved red blood cell production. Lab values are preferred for evaluating medication effectiveness.
C. Food diary shows increased consumption of iron-rich foods: Dietary improvements support erythropoiesis but are not the direct measure of epoetin alfa’s effect. The medication’s success is best gauged by the actual rise in hemoglobin, not dietary habits alone.
D. Takes concurrent iron therapy without adverse effects: Iron supplementation is often needed to maximize epoetin alfa’s effect, but merely tolerating iron therapy does not confirm that epoetin alfa is working to correct the anemia. The focus remains on hemoglobin response.
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