A nurse is caring for a client who has a new diagnosis of adrenal insufficiency. Which of the following prescriptions should the nurse anticipate from the provider?
Phenytoin.
Calcitonin.
Buspirone.
Fludrocortisone.
The Correct Answer is D
Choice A rationale
Phenytoin is an anticonvulsant used to control seizures and is not indicated for the treatment of adrenal insufficiency.
Choice B rationale
Calcitonin is used to treat conditions like osteoporosis and hypercalcemia, not adrenal insufficiency.
Choice C rationale
Buspirone is an anxiolytic used to treat anxiety disorders and is not used for adrenal insufficiency.
Choice D rationale
Fludrocortisone is a synthetic corticosteroid that is used to replace aldosterone in patients with adrenal insufficiency. It helps maintain sodium balance and blood pressure.
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Correct Answer is A
Explanation
Choice A rationale
A neutrophil count of 650/mm³ is significantly lower than the normal range (2,500 to 8,000/mm³) and indicates neutropenia, which is a known adverse effect of zidovudine. Neutropenia increases the risk of infections and requires close monitoring and potential dose adjustment or discontinuation of the medication.
Choice B rationale
A platelet count of 450,000/mm³ is slightly above the normal range (150,000 to 400,000/mm³) but is not typically associated with zidovudine toxicity. Zidovudine is more commonly associated with bone marrow suppression leading to anemia and neutropenia rather than thrombocytosis.
Choice C rationale
An Hgb level of 17 g/dL is above the normal range for females (12 to 16 g/dL) but is not a common adverse effect of zidovudine. Zidovudine is more likely to cause anemia, leading to lower hemoglobin levels rather than elevated levels.
Choice D rationale
A creatinine level of 1.5 mg/dL is within the upper limit of the normal range (0.5 to 1 mg/dL) and is not a typical adverse effect of zidovudine. Zidovudine primarily affects the bone marrow and does not have a significant impact on renal function.
Correct Answer is C
Explanation
Choice A rationale
Expecting to have drowsiness while taking this medication is a common side effect of many seizure medications. However, it is not an indication of understanding the teaching about seizure medication management.
Choice B rationale
Taking an extra dose of the medication if a dose is missed is incorrect. Patients should not take an extra dose if they miss one. They should follow their healthcare provider’s instructions on what to do if a dose is missed.
Choice C rationale
Having blood checked to monitor the medication level indicates an understanding of the teaching. Monitoring blood levels of seizure medications is important to ensure therapeutic levels and avoid toxicity.
Choice D rationale
Taking the medication with an antacid to prevent indigestion is incorrect. Antacids can interfere with the absorption of some seizure medications.