A patient taking montelukast (Singulair) for the last 2 months has the following blood laboratory test values. Which value does the nurse report to the prescriber immediately?
a. White blood cell count of 10,500 cells/mm3
b. Lactate dehydrogenase 950 IU/L
c. Potassium 3.6 mEq/L
d. Hematocrit 32%
B
The white blood cell count, lactate dehydrogenase, and hematocrit values are abnormal; however, only the lactate dehydrogenase level is very high (four to five times normal). This value indicates liver impairment. Leukotriene inhibitors can cause liver impairment. This value must be reported immediately so that liver function can be explored and any needed changes in drug therapy made before irreversible liver damage occurs.
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