A patient admitted to the emergency department with abdominal pain tells the nurse he has been taking kava. Which of the following should be included in the nurse's evaluation of this patient? (Select all that apply.)
a. Ask the patient to provide a urine sample to assess color.
b. Check the sclera for yellowing.
c. Listen to the apical rate for tachycardia.
d. Ask the patient to provide a stool sample to assess color.
e. Obtain serum liver function studies.
ANS: A, B, C, D
In 2002, the Centers for Disease Control and Prevention (CDC) issued a report outlining the association between kava and hepatotoxicity. In 11 cases, patients developed liver failure and required transplantation. Because this patient complained of abdominal pain, the nurse should further explore for signs of liver disease, such as brown urine, yellow sclera, and light-colored stools. Liver function tests should also be obtained to determine whether kava has affected the liver.
Tachycardia is not associated with kava use.
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