A client is started on gemfibrozil to assist in the lowering of triglyceride level. Which of the following side effects is associated with gemfibrozil?
gallstones
decreased PT time
hyperkalemia
Increased creatinine clearance
The Correct Answer is A
A) Gallstones: Gemfibrozil is associated with an increased risk of gallstones. This medication can alter the metabolism of lipids and bile, potentially leading to the formation of gallstones. Clients should be monitored for symptoms such as abdominal pain or discomfort that could indicate gallbladder issues.
B) Decreased PT time: Gemfibrozil does not typically affect prothrombin time (PT). Instead, it may interact with anticoagulants and potentially increase PT time, requiring careful monitoring in patients taking both medications.
C) Hyperkalemia: While hyperkalemia can occur with certain lipid-lowering medications, it is not a common side effect associated with gemfibrozil. This drug primarily affects triglycerides and cholesterol levels without significantly impacting potassium levels.
D) Increased creatinine clearance: Gemfibrozil is not known to increase creatinine clearance; in fact, it can sometimes affect renal function. Monitoring kidney function is important, but increased creatinine clearance is not an expected outcome with this medication.
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Correct Answer is C
Explanation
A) Platelet counts: Monitoring platelet counts is not necessary with atorvastatin therapy. While certain medications may affect platelet levels, atorvastatin primarily targets lipid levels and does not have a significant impact on platelet function.
B) Lung function test: Lung function tests are not relevant for atorvastatin use. These tests are typically utilized for assessing respiratory conditions and are not part of the routine monitoring for cholesterol-lowering medications.
C) Liver function test: Atorvastatin can affect liver function, so it is essential to monitor liver
enzymes (such as AST and ALT) regularly. Routine liver function tests help identify any potential hepatotoxicity early, allowing for timely intervention if liver function declines.
D) Bun and creatinine levels: While monitoring renal function can be important in some contexts, it is not a routine requirement specifically for atorvastatin. However, it may be necessary in certain patient populations or if there are concerns about kidney function, but liver function tests are the primary focus with this medication.
Correct Answer is D
Explanation
A. "Depending on the level of your PT/INR, the clot will begin to dissolve.": This response is misleading, as heparin's effect is not primarily monitored by PT/INR; rather, heparin is monitored by activated partial thromboplastin time (aPTT). Moreover, heparin does not directly dissolve clots; it prevents further clot formation.
B. "After the first dose, the clot will begin to dissolve.": This statement inaccurately suggests that heparin has an immediate effect on dissolving existing clots. While heparin acts quickly to inhibit further clotting, it does not lead to the dissolution of clots after the first dose.
C. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level.": This is not accurate for heparin, which has an immediate effect on coagulation. While the therapeutic effects can be optimized over several days, heparin begins to work right away to prevent further clotting.
D. "Heparin does not dissolve clots. It stops new clots from forming.": This response accurately describes the mechanism of action of heparin. Heparin prevents the extension of existing clots and the formation of new clots, but it does not actively dissolve clots. This clarification is essential for the client’s understanding of their treatment and expectations regarding DVT management.