A nurse is caring for a client who has been taking captopril for one year. Which of the following laboratory values should the nurse review? (Select all that apply.)
Potassium level.
WBC with differential.
BUN level.
Hemoglobin level.
Glucose level.
Correct Answer : A,B,C
Choice A rationale
Potassium level should be reviewed because captopril can cause hyperkalemia due to its effect on aldosterone secretion.
Choice B rationale
WBC with differential should be reviewed because captopril can cause neutropenia or agranulocytosis, especially in patients with renal impairment or collagen vascular disease.
Choice C rationale
BUN level should be reviewed because captopril can affect renal function, leading to increased BUN levels.
Choice D rationale
Hemoglobin level is not typically affected by captopril, so it is not a priority for review.
Choice E rationale
Glucose level is not typically affected by captopril, so it is not a priority for review.
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Correct Answer is B
Explanation
Choice A rationale
Experiencing a rash while taking allopurinol is not harmless. It can be a sign of a serious allergic reaction, such as Stevens-Johnson syndrome or toxic epidermal necrolysis.
Choice B rationale
Increasing fluid intake is crucial when taking allopurinol. It helps to prevent kidney stones and ensures that uric acid is effectively excreted from the body.
Choice C rationale
Increasing dietary fiber intake is not specifically related to the use of allopurinol. While fiber is beneficial for overall health, it does not directly impact the effectiveness or safety of allopurinol.
Choice D rationale
Taking one dose every hour until the pain subsides is incorrect and dangerous. Allopurinol should be taken as prescribed by a healthcare provider, typically once or twice daily.
Correct Answer is C
Explanation
Choice A rationale
Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.
Choice B rationale
Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.
Choice C rationale
Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.
Choice D rationale
Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.