A nurse is reviewing the laboratory findings for a female client who is taking zidovudine to treat HIV. Which of the following should the nurse identify as an adverse finding associated with this medication?
Neutrophil count 650/mm³ (2,500 to 8,000/mm³).
Platelets 450,000/mm³ (150,000 to 400,000/mm³).
Hgb 17 g/dL (12 to 16 g/dL).
Creatinine 1.5 mg/dL (0.5 to 1 mg/dL).
The Correct Answer is A
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.
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Correct Answer is A
Explanation
Choice A rationale
Elevated alanine aminotransferase (ALT) is an adverse effect of simvastatin therapy. Statins, including simvastatin, can cause liver damage, which is indicated by elevated liver enzymes such as ALT2.
Choice B rationale
Elevated troponin T is not typically associated with simvastatin therapy. Troponin T is a marker for cardiac muscle damage, not a common adverse effect of statins.
Choice C rationale
Elevated WBC count is not a known adverse effect of simvastatin therapy. An elevated WBC count usually indicates an infection or inflammation.
Choice D rationale
Elevated thyroid-stimulating hormone (TSH) is not associated with simvastatin therapy. TSH levels are related to thyroid function, not the effects of statins.
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.