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
Gargling with water after using a beclomethasone inhaler helps prevent oral candidiasis (thrush), a common side effect of inhaled corticosteroids.
Choice B rationale
Using a spacer with a beclomethasone inhaler can help improve drug delivery to the lungs and reduce the risk of side effects. It is generally recommended to use a spacer with inhaled corticosteroids.
Choice C rationale
Beclomethasone is not a rescue inhaler and should not be used for acute incidents of shortness of breath. It is a maintenance medication used to control chronic asthma symptoms.
Choice D rationale
Albuterol should be used before beclomethasone to open the airways and enhance the absorption of the corticosteroid. Using beclomethasone first does not increase absorption and is not the recommended practice.
Correct Answer is C
Explanation
Choice A rationale
Metoclopramide is not used to suppress cough. It is primarily used to treat nausea, vomiting, and gastroparesis.
Choice B rationale
Metoclopramide does not have a primary effect on muscle relaxation. Its main action is to increase gastrointestinal motility.
Choice C rationale
Reduced nausea is a primary outcome for evaluating the effectiveness of metoclopramide. It is commonly prescribed to manage nausea and vomiting.
Choice D rationale
Metoclopramide is not typically used to decrease pain. Its primary indications are related to gastrointestinal symptoms.