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
Benzonatate is a non-narcotic cough suppressant that works by numbing the throat and lungs, making the cough reflex less active. It can cause drowsiness and dizziness, so patients are advised not to drive or operate heavy machinery while taking this medication.
Choice B rationale
Benzonatate does not help in coughing up mucus. It suppresses the cough reflex, which can be beneficial for dry, irritating coughs but is not suitable for productive coughs where mucus needs to be expelled.
Choice C rationale
There is no need to decrease dietary fiber intake while taking benzonatate. Dietary fiber does not interact with the medication or its effectiveness.
Choice D rationale
Benzonatate capsules should not be chewed or crushed, as this can cause numbness of the mouth and throat, leading to potential choking hazards.
Correct Answer is B
Explanation
Choice A rationale
BNP is used to diagnose heart failure, not to monitor gentamicin’s adverse effects.
Choice B rationale
Creatinine levels should be monitored as gentamicin can cause nephrotoxicity, leading to impaired kidney function.
Choice C rationale
Amylase levels are not relevant for detecting gentamicin’s adverse effects.
Choice D rationale
ESR is used to detect inflammation, not specific to gentamicin’s adverse effects.