The nurse manages care for a patient with diabetes who takes metformin. Which laboratory result would cause the greatest concern?
a. Elevated creatinine
b. Anemia
c. Decreased platelets
d. Increased iron
ANS: A
An increased creatinine level indicates renal dysfunction. This would cause serious concern, because metformin is excreted unchanged by the kidneys, and with renal impairment, metformin can accumulate to toxic levels.
Anemia, decreased platelets, and increased iron are secondary concerns that need to be managed; however, the most significant concern is definitely the increased creatinine level, which signals renal dysfunction.
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