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 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.
Correct Answer is B
Explanation
A. A high first-pass effect means that a significant amount of the drug is metabolized by the liver before reaching systemic circulation, making oral administration less effective.
B. Morphine with a high first-pass effect will be more effective when administered via non-enteral routes, such as IV or subcutaneous, to bypass the liver's initial metabolism.
C. The first-pass effect does not influence the kidney’s rate of excretion but rather the liver’s initial metabolism of the drug.
D. The liver, not the kidneys, is responsible for the first-pass metabolism, which occurs before the drug reaches systemic circulation when taken orally.