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","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.
Correct Answer is ["A","B","C","D","F"]
Explanation
Choice A rationale
Assessing the client’s gag reflex before offering oral intake is essential to prevent aspiration. The gag reflex may be diminished after moderate sedation and the use of local anesthetics during bronchoscopy.
Choice B rationale
Listening to the client’s breath sounds is important to detect any abnormalities, such as wheezing, crackles, or decreased breath sounds, which could indicate complications like bronchospasm or pneumothorax.
Choice C rationale
Monitoring the client’s oxygen saturation is crucial to ensure adequate oxygenation and detect any signs of respiratory distress or hypoxemia following the procedure.
Choice D rationale
Monitoring the client for manifestations of bleeding is necessary because bronchoscopy can cause trauma to the airways, leading to bleeding. Signs of bleeding may include hemoptysis or a drop in hemoglobin levels.
Choice E rationale
Assessing the client’s puncture site is not applicable in this context, as bronchoscopy does not involve a puncture site. This option is incorrect.
Choice F rationale
Observing the client for manifestations of a pneumothorax is important because bronchoscopy can occasionally cause a pneumothorax, especially if a biopsy is performed. Signs of pneumothorax include sudden chest pain, dyspnea, and decreased breath sounds on the affected side. .