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","B","D","E"]
Explanation
Choice A rationale
Contacting the provider is essential to inform them of the error and receive further instructions on managing the client’s condition.
Choice B rationale
Reporting the error to the charge nurse is necessary for proper documentation and to ensure that corrective actions are taken to prevent future errors.
Choice C rationale
Incident reports should not be placed in the client’s chart. They are for internal use to improve safety and quality of care.
Choice D rationale
Auscultating the client’s lungs is important to check for signs of fluid overload, such as crackles or wheezing.
Choice E rationale
Checking for peripheral edema helps assess the extent of fluid overload and its impact on the client’s condition.
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.