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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View Related questions
Correct Answer is A
Explanation
Choice A rationale
A neutrophil count of 650/mm³ is significantly lower than the normal range (2,500 to 8,000/mm³) and indicates neutropenia, which is a known adverse effect of zidovudine. Neutropenia increases the risk of infections and requires close monitoring and potential dose adjustment or discontinuation of the medication.
Choice B rationale
A platelet count of 450,000/mm³ is slightly above the normal range (150,000 to 400,000/mm³) but is not typically associated with zidovudine toxicity. Zidovudine is more commonly associated with bone marrow suppression leading to anemia and neutropenia rather than thrombocytosis.
Choice C rationale
An Hgb level of 17 g/dL is above the normal range for females (12 to 16 g/dL) but is not a common adverse effect of zidovudine. Zidovudine is more likely to cause anemia, leading to lower hemoglobin levels rather than elevated levels.
Choice D rationale
A creatinine level of 1.5 mg/dL is within the upper limit of the normal range (0.5 to 1 mg/dL) and is not a typical adverse effect of zidovudine. Zidovudine primarily affects the bone marrow and does not have a significant impact on renal function.
Correct Answer is C
Explanation
Choice A rationale
Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.
Choice B rationale
Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.
Choice C rationale
Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.
Choice D rationale
Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.