A patient taking ketoconazole (Nizoral) for the last 2 weeks has all of the following blood laboratory test values. Which value does the nurse report to the prescriber immediately?
a. White blood cell count (WBC) 10,500 cells/mm3
b. Lactate dehydrogenase 880 IU/L
c. Potassium 3.6 mEq/L
d. Hematocrit 32%
B
The WBC count, lactate dehydrogenase, and hematocrit values are abnormal; however, only the lactate dehydrogenase level is very high (three to four times normal). This value indicates liver impairment, which can be caused by taking ketoconazole. This value must be reported imme-diately so that liver function can be explored and any needed changes in drug therapy made be-fore irreversible liver damage occurs.
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