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 A
Explanation
Choice A rationale
Gargling with water after using a beclomethasone inhaler helps prevent oral candidiasis (thrush), a common side effect of inhaled corticosteroids.
Choice B rationale
Using a spacer with a beclomethasone inhaler can help improve drug delivery to the lungs and reduce the risk of side effects. It is generally recommended to use a spacer with inhaled corticosteroids.
Choice C rationale
Beclomethasone is not a rescue inhaler and should not be used for acute incidents of shortness of breath. It is a maintenance medication used to control chronic asthma symptoms.
Choice D rationale
Albuterol should be used before beclomethasone to open the airways and enhance the absorption of the corticosteroid. Using beclomethasone first does not increase absorption and is not the recommended practice.
Correct Answer is E
Explanation
Choice A rationale
Hypercalcemia is not typically a risk in the emergency department unless the patient has a specific condition that causes elevated calcium levels.
Choice B rationale
Hypotension can occur in the emergency department, especially in cases of shock or severe dehydration, but it is not the most common risk.
Choice C rationale
Hypokalemia can occur, particularly in patients with certain medical conditions or those taking diuretics, but it is not the most common risk.
Choice D rationale
Hypernatremia can occur, especially in patients with dehydration or certain medical conditions, but it is not the most common risk.
Choice E rationale
Hypoglycemia is a common risk in the emergency department, especially in patients with diabetes or those who have not eaten for an extended period.