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 C
Explanation
Choice A rationale
A standing prescription is an order that applies to all patients who meet certain criteria and is not specific to a single administration. It is used for routine treatments and does not apply to a one-time pre-transfusion medication.
Choice B rationale
A stat prescription is an urgent order that requires immediate administration, typically within minutes. It is used for emergency situations and does not apply to a pre-transfusion medication given one hour before the procedure.
Choice C rationale
A single prescription is a one-time order for a specific medication to be given at a specific time. In this case, diphenhydramine 50 mg by mouth once, one hour prior to transfusion, fits the definition of a single prescription.
Choice D rationale
A PRN (pro re nata) prescription is an order for medication to be given as needed based on the patient’s condition. It is not applicable to a scheduled pre-transfusion medication.
Correct Answer is ["A","E"]
Explanation
Choice A rationale
Muscle weakness is a common symptom of hypokalemia due to decreased potassium levels affecting muscle function.
Choice B rationale
Hyperactive bowel sounds can indicate hypokalemia because potassium is essential for normal gastrointestinal motility. Low potassium levels can lead to increased activity in the intestines, resulting in hyperactive bowel sounds.
Choice C rationale
Tingling of fingers, or paresthesia, can be a symptom of hypokalemia, as low potassium levels may affect nerve conduction. This results in abnormal sensations like tingling or numbness.
Choice D rationale
Peaked T waves are more commonly associated with hyperkalemia rather than hypokalemia. Therefore, this option would not indicate hypokalemia. However, a nurse should be vigilant about monitoring potassium levels as both conditions can lead to significant cardiovascular effects.
Choice E rationale
Fatigue is another symptom of hypokalemia as low potassium levels can impair cellular function and energy production.