A nurse is reviewing the lab work of a client on a medical-surgical unit who has a new prescription for captopril. Which of the following laboratory values should the nurse identify as the priority to monitor?
Alanine aminotransferase
Thyroid-stimulating hormone
Potassium
Magnesium
The Correct Answer is C
Rationale:
A. Monitoring alanine aminotransferase is important for liver function, but it is not the priority for a client on captopril.
B. Thyroid-stimulating hormone is not directly impacted by captopril and is not the priority lab value to monitor in this context.
C. Potassium is the priority laboratory value to monitor because captopril, an ACE inhibitor, can lead to hyperkalemia (elevated potassium levels), which can cause serious cardiac complications.
D. While magnesium levels are important to monitor, they are not specifically related to captopril therapy as potassium levels are.
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Correct Answer is A
Explanation
Rationale:
A. The pharmacist typically restocks the medication drawer each day to ensure that medications are available and up-to-date. This is an essential component of the unit-dose medication system.
B. The nursing supervisor does not usually unlock the medication drawer; this is typically done by the nurse in charge or the individual administering the medications.
C. While it is important to limit the number of controlled substances, the medication drawer is usually stocked in a manner that allows for easy access to necessary medications, and there are regulations that govern this process.
D. Opened medications should not necessarily be disposed of at the end of each shift; they may be retained if they are still within their stability period and are properly stored according to protocols.
Correct Answer is D
Explanation
Rationale:
A. Cataracts are not a contraindication for cholinesterase inhibitors like neostigmine.
B. Hypertension is not a direct contraindication for cholinesterase inhibitor therapy, although caution may be exercised depending on the overall health status of the client.
C. Hypothyroidism is not contraindicated for cholinesterase inhibitors; however, it should be managed appropriately.
D. Peptic ulcer disease is a significant contraindication for cholinesterase inhibitors like neostigmine because these medications can increase gastric secretions and motility, potentially exacerbating ulcer conditions and leading to complications.