The nurse is caring for a patient in the hospital for pneumonia but also has a severe case of psoriasis that is being treated with methotrexate
During the morning assessments, which of the following lab values would alert the nurse that the patient may be experiencing a side effect to this medication? Select all that apply.
A)
Serum potassium (K+) level 3.6 mmol/L
B)
Platelet count 37 × 103/ µL
C)
Alanine aminotransferase (ALT) 28 units/L
D)
White blood cell count 1.2 × 103/ µL
Ans:
B, D
Feedback:
Methotrexate is an antimetabolite that inhibits DNA synthesis and prevents cell mitosis. Oral methotrexate has been effective in treating psoriasis when other approaches have failed. The side effects include nausea, leukopenia (low WBC count), thrombocytopenia (low platelet count), and liver function abnormalities. The low platelet count corresponds to thrombocytopenia, and the low WBC corresponds to leucopenia. The other lab values, K+ and ALT, are within the normal adult range.
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