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 B
Explanation
Choice A rationale
Weight gain is not a common side effect of pramlintide. Monitoring for hypoglycemia is more critical.
Choice B rationale
Pramlintide can cause hypoglycemia, especially within 3 hours after administration. Monitoring for hypoglycemia is essential.
Choice C rationale
Pramlintide should be injected into the abdomen or thigh, not the upper arm.
Choice D rationale
Pramlintide should be administered immediately before a meal, not 30 minutes prior.
Correct Answer is D
Explanation
Choice A rationale
Limiting caffeine is not the first action the nurse should take. While caffeine can exacerbate symptoms of BPH, it is not the priority action when starting doxazosin IR3.
Choice B rationale
Reporting headaches is important, but it is not the first action the nurse should take. Headaches can be a side effect of doxazosin, but monitoring the patient’s initial response to the medication is more critical.
Choice C rationale
Measuring the client’s intake and output is important for monitoring urinary symptoms, but it is not the first action the nurse should take when starting doxazosin IR3.
Choice D rationale
Administering the medication at bedtime is the correct first action. Doxazosin can cause dizziness and hypotension, especially after the first dose, so taking it at bedtime can help minimize these effects.