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 C
Explanation
Choice A rationale
Incorrect packaging, such as a topical medication packaged as an oral medication, can lead to medication errors. However, it is not the most frequent cause of fatal medication errors. Packaging errors are relatively rare and usually caught before administration.
Choice B rationale
Delivery device problems, such as an infusion pump malfunction, can cause medication errors. These errors can be serious but are not the most frequent cause of fatal medication errors. Device malfunctions are often detected and corrected by healthcare professionals.
Choice C rationale
Name confusion between two medications with similar sounding names is the most frequent cause of fatal medication errors. This type of error occurs when medications with similar names are confused, leading to the administration of the wrong drug. This can have serious and sometimes fatal consequences.
Choice D rationale
Incorrect labeling of a medication dispensed by the pharmacy can lead to medication errors. While labeling errors are a significant concern, they are not the most frequent cause of fatal medication errors. These errors are often identified and corrected before administration.
Correct Answer is B
Explanation
Choice A rationale
Dependent edema is not a common adverse effect of gemfibrozil. It is more commonly associated with other conditions such as heart failure.
Choice B rationale
Muscle tenderness is a known adverse effect of gemfibrozil. It can indicate myopathy or rhabdomyolysis, which are serious conditions that require medical attention.
Choice C rationale
Tremors are not a common adverse effect of gemfibrozil. They are more commonly associated with neurological conditions or other medications.
Choice D rationale
Hyperkalemia is not a common adverse effect of gemfibrozil. It is more commonly associated with medications that affect renal function or potassium balance. .