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 D
Explanation
Choice A rationale
Asthma is not a contraindication for sumatriptan. Sumatriptan is a selective serotonin receptor agonist used to treat migraines by constricting blood vessels in the brain. It does not have a significant impact on respiratory conditions like asthma.
Choice B rationale
Kidney disease is not a contraindication for sumatriptan. However, caution is advised when using sumatriptan in patients with severe renal impairment due to potential accumulation of the drug and its metabolites.
Choice C rationale
Rheumatoid arthritis is not a contraindication for sumatriptan. Sumatriptan’s mechanism of action does not interfere with the inflammatory processes involved in rheumatoid arthritis.
Choice D rationale
Coronary artery disease (CAD) is a contraindication for sumatriptan. Sumatriptan can cause vasoconstriction of coronary arteries, which can exacerbate CAD and increase the risk of myocardial infarction or other cardiac events.
Correct Answer is A
Explanation
Choice A rationale
Elevated alanine aminotransferase (ALT) is an adverse effect of simvastatin therapy. Statins, including simvastatin, can cause liver damage, which is indicated by elevated liver enzymes such as ALT2.
Choice B rationale
Elevated troponin T is not typically associated with simvastatin therapy. Troponin T is a marker for cardiac muscle damage, not a common adverse effect of statins.
Choice C rationale
Elevated WBC count is not a known adverse effect of simvastatin therapy. An elevated WBC count usually indicates an infection or inflammation.
Choice D rationale
Elevated thyroid-stimulating hormone (TSH) is not associated with simvastatin therapy. TSH levels are related to thyroid function, not the effects of statins.