A client arrives at the healthcare setting currently taking atorvastatin (Lipitor) daily. Which assessment finding associated with atorvastatin (Lipitor) would need immediate reporting to the healthcare provider?
bradycardia
dark-red urine
elevated HDL cholesterol
migraine headache
The Correct Answer is B
A. Bradycardia is not a common side effect of atorvastatin and would not necessarily require immediate reporting unless it is significantly low and symptomatic.
B. Dark-red urine could indicate the presence of myoglobinuria, which can occur due to rhabdomyolysis, a serious side effect of statins like atorvastatin that necessitates immediate medical attention.
C. Elevated HDL cholesterol is generally a positive finding and does not require reporting unless it is part of a larger adverse effect context.
D. A migraine headache, while concerning, is not a known side effect specifically associated with atorvastatin and may not require immediate intervention unless severe or persistent.
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Correct Answer is ["B","C","F"]
Explanation
A. Morphine administered intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect entirely.
B. Diphenhydramine in tablet form is absorbed through the gastrointestinal tract and undergoes significant first-pass metabolism in the liver, affecting its bioavailability.
C. Famotidine in tablet form is also subject to first-pass metabolism, which can reduce its effectiveness.
D. Nitroglycerin sublingual tablets are designed to bypass the first-pass metabolism by being absorbed directly into the bloodstream through the mucous membranes.
E. The same applies to nitroglycerin 10mg sublingual tablets; they also avoid the first-pass effect due to sublingual administration.
F. Acetaminophen is taken orally and undergoes first-pass metabolism in the liver, which can significantly affect its overall bioavailability.
Correct Answer is A
Explanation
A. Sodium intake is crucial for clients on lithium, as low sodium levels can lead to lithium toxicity; therefore, maintaining a normal sodium level is important.
B. While potassium is important for general health, it does not specifically impact lithium levels.
C. Vitamin C is beneficial for overall health but does not have a direct relationship with lithium therapy.
D. Vitamin K is related to blood clotting and does not have a significant interaction with lithium treatment or its efficacy.